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The article discusses spontaneous intracranial hypotension (SIH), a clinical condition characterized by postural headaches caused by the spontaneous leakage of cerebrospinal fluid (CSF) into the extradural space. The most common cause of CSF leakage is a longitudinal dural tear, meningeal diverticulum, or direct cerebrospinal venous fistula (LVF). SIH is an underdiagnosed condition with an incidence of 5 per 100,000 people per year, typically affecting individuals between the ages of 40-50, with a higher prevalence in women. The article presents a case study of a 61-year-old woman with SIH who underwent surgical treatment, resulting in the resolution of her symptoms. The article also discusses the diagnosis and treatment of LVF, a potential cause of SIH. [Extracted from the article]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

PURPOSE OF THE STUDY This article presents the evidence and the rationale for the recommendations for surgical treatment of degenerative lumbar stenosis (DLS) and spondylolisthesis that were recently developed as a part of the Czech Clinical Practice Guideline (CPG) “The Surgical Treatment of the Degenerative Diseases of the Spine”. MATERIAL AND METHODS The Guideline was drawn up in line with the Czech National Methodology of the CPG Development, which is based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. We used an innovative GRADE-adolopment method that combines adoption and adaptation of the existing guidelines with de novo development of recommendations. In this paper, we present three adapted recommendations on DLS and a recommendation on spondy-lolisthesis developed de novo by the Czech team. RESULTS Open surgical decompression in DLS patients has been evaluated in three randomized controlled trials (RCTs). A recommendation in favour of decompression was made based on a statistically significant and clinically evident improvement in the Oswestry Disability Index (ODI) and leg pain. Decompression may be recommended for patients with symptoms of DLS in the event of correlation of significant physical limitation and the finding obtained via imaging. The authors of a systematic review of observational studies and one RCT conclude that fusion has a negligible role in the case of a simple DLS. Thus, spondylodesis should only be chosen as an adjunct to decompression in selected DLS patients. Two RCTs compared supervised rehabilitation with home or no exercise, showing no statistically significant difference between the procedures. The guideline group considers the post-surgery physical activity beneficial and suggests supervised rehabilitation in patients who have undergone surgery for DLS for the beneficial effects of exercise in the absence of known adverse effects. Four RCTs were found comparing simple decompression and decompression with fusion in patients with degenerative lumbar spondylolisthesis. None of the outcomes showed clinically significant improvement or deterioration in favour of either intervention. The guideline group concluded that for stable spondylolisthesis the results of both methods are comparable and, when other parameters are considered (balance of benefits and risks, or costs), point in favour of simple decompression. Due to the lack of scientific evidence, no recommendation has been formulated regarding unstable spondylolisthesis. The certainty of the evidence was rated as low for all recommendations. DISCUSSION Despite the unclear definition of stable/unstable slip, the inclusion of apparently unstable cases of DS in stable studies limits the conclusions of the studies. Based on the available literature, however, it can be summarized that in simple degenerative lumbar stenosis and static spondylolisthesis, fusion of the given segment is not justified. However, its use in the case of unstable (dynamic) vertebral slip is undisputable for the time being. CONCLUSIONS The guideline development group suggests decompression in patients with DLS in whom previous conservative treatment did not lead to improvement, spondylodesis only in selected patients, and post-surgical supervised rehabilitation. In patients with degenerative lumbar stenosis and spondylolisthesis with no signs of instability, the guideline development group suggests simple decompression (without fusion). [ABSTRACT FROM AUTHOR]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Brain metastases are serious complication of cancer. Progress in brain imaging, intraoperative electrophysiological monitoring and neurosurgical equipment have increased the extent of the resection and safety of neurosurgical operations while reducing mortality and morbidity. Surgical resection is still the first considered therapeutic option. It is especially recommended for patients with solitary cerebral metastasis in accessible localization, in good clinical conditions and with favourable prognosis. It is relatively contraindicated in the case of uncontrolled cancer disease, poor clinical conditions, in the case of radiosensitive tumours, poor disease prognosis and presence of more than three cerebral metastases. Surgical therapy for two or three metastases is also possible, but its role may be questionable in some aspects. General recommendations are not clearly defined in the case of recurrent metastases as well, and individual assessment is preferred based on the evaluation of the number of prognostic factors. The Editorial Board declares that the manuscript met the ICMJE "uniform requirements" for biomedical papers. [ABSTRACT FROM AUTHOR]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It is known (G. Choquet, G. Mokobodzki) that a Baire-one affine function on a compact convex set satisfies the barycentric formula and can be expressed as a pointwise limit of a sequence of continuous affine functions. Moreover, the space of Baire-one affine functions is uniformly closed. The aim of this paper is to discuss to what extent analogous properties are true in the context of general function spaces. In particular, we investigate the function spaceH(U), consisting of the functions continuous on the closure of a bounded open setU⊂ℝm and harmonic onU, which has been extensively studied in potential theory. We demonstrate that the barycentric formula does not hold for the spaceB1b(H(U)) of bounded functions which are pointwise limits of functions from the spaceH(U) and thatB1b(H(U)) is not uniformly closed. On the other hand, every Baire-oneH(U)-affine function (in particular a solution of the generalized Dirichlet problem for continuous boundary data) is a pointwise limit of a bounded sequence of functions belonging toH(U). It turns out that such a situation always occurs for simplicial spaces whereas it is not the case for general function spaces. The paper provides several characterizations of those Baire-one functions which can be approximated pointwise by bounded sequences of elements of a given function space. [ABSTRACT FROM AUTHOR]