Basilar Invagination: A Craniocervical Kyphosis

Botelho, Ricardo Vieira; Ferreira, Jânio Alves; Ferreira, Édson Dener Zandonadi

doi:10.1016/j.wneu.2018.05.233

Cited by 28 publications

(10 citation statements)

References 13 publications

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“…In the Nepalese population, our study showed a mean of 127.89 degrees (SD 6.4), which seems to be within the range of previous studies of Filipino, Indian, Brazilian, North American, and Turkish populations. 8,9,10 Among them the reference range of our study seems to be very close to the study performed in the Indian population. This might be due to open border policy between Nepalese and Indian territory, cultural similarity, and similar body structure of south Asian territory.…”

Section: Discussionsupporting

confidence: 79%

“…3,8 The normal value of basal angle seems to range between 100 to 128 degree in difference literature. 8,9 The reference range of basal angle seems to vary with geographical variation and also the technique of measurement. In the Nepalese population, our study showed a mean of 127.89 degrees (SD 6.4), which seems to be within the range of previous studies of Filipino, Indian, Brazilian, North American, and Turkish populations.…”

Section: Discussionmentioning

confidence: 99%

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Clival canal Angle and Basal Angle in Nepalese Population- A Computed Tomography Based Study

Rajbanshi¹,

Chaudhary²,

Nepal³

et al. 2020

Eastern Green Neurosurg.

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Background: Clival canal angle is an angle formed by the clivus and the posterior longitudinal ligament of the cervical spine and Welcher basal angle formed between the line joining the nasion to tuberculumSella and the line joining the tuberculum sellae to basion along the plane of clivus. With the aim to review the normal distribution of clival canal angle and basal angle in the Nepalese population this study was performed. Methods and materials: This is a cross-sectional analytical study with non- probability consecutive sampling technique done over the duration of 3 months. A reconstructed image of a bone window in the midsagittal plane was selected and measurement of the angles was done in CT console. Results: There was a total of 60 patients in this study with male predominance (figure 3). The mean age of the population was 49.8 (SD 18.8) years. The clival canal angle reference range was 130.8 to 168.8 degrees with a mean 149.8(SD 9.5) degree. Similarly, the reference range of Welcher basal angle in the study population was 115.49 to 140.29 degree with a mean of 127.89(SD: 6.4) degrees. Conclusion: The mean clival canal angle in the Nepalese population is 149.8 (SD: 9.5) degrees and the mean basal angle is 127.89(SD: 6.4) degree.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Clival canal Angle and Basal Angle in Nepalese Population- A Computed Tomography Based Study

Rajbanshi¹,

Chaudhary²,

Nepal³

et al. 2020

Eastern Green Neurosurg.

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“…In particular, CLV of patients with Chiari I malformation has been found to be similar to that of control subjects. 32,33 This supports and explains our finding that CLV was normal in 5/6 patients with true-positive IONM signal changes, and that there was no difference in CLV between the positive and negative IONM signal change groups.…”

Section: Discussionsupporting

confidence: 74%

Intraoperative neuromonitoring for pediatric Chiari decompression: when is it useful?

Sen

Martı́nez

Eaton

et al. 2023

Neurosurgical Focus

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OBJECTIVE Surgical treatment for symptomatic Chiari I malformation involves surgical decompression of the craniovertebral junction. Given the proximity of critical brainstem structures, intraoperative neuromonitoring (IONM) is employed for safe decompression in some institutions. However, IONM adds time and cost to the operation, and the benefit to the patient has not been defined. Given the diversity in surgical practices, there is no evidence-based standard of care regarding when to use IONM and which modalities are most helpful. The purpose of this study was to review a single-surgeon experience with IONM in order to determine the sensitivity, specificity, and predictive values of various IONM modalities routinely used in pediatric Chiari I decompression; to examine the associations between patient, clinical, and radiographic characteristics and IONM alerts; and to obtain data regarding the usefulness of these modalities during the surgical process to improve patient outcomes. METHODS A retrospective review was performed for 300 consecutive pediatric patients who underwent suboccipital craniectomy and C1 laminectomy for Chiari decompression performed by a single surgeon over a 15-year period. Clinical, radiographic, and IONM data were collected. Radiographic measurements of the skull base morphological abnormalities, including clival angle, Chamberlain’s line, and Grabb-Oakes line, were compared between patients with and without true IONM signal changes. RESULTS A total of 291 cases were included, with an age range of 6 months to 19 years. Among 291 cases, somatosensory evoked potentials (SSEPs) were monitored in 291, motor evoked potentials (MEPs) in 209, cranial nerve spontaneous electromyography (sEMG) in 290, and brainstem auditory evoked potentials (BAEPs) in 110. Sensitivity, specificity, positive predictive value, and negative predictive value, respectively, were as follows: 1.00, 1.00, 1.00, and 1.00 for SSEPs; 1.00, 0.99, 0.67, and 1.00 for MEPs; 0.00, 0.88, 0.00, and 1.00 for sEMG; and not appliable, 1.00, not applicable, and 1.00 for BAEPs. Six patients had true IONM signal changes. These patients had radiographic evidence of more severe concomitant craniocervical instability and basilar invagination, with steeper clival angles (124° vs 146°, p = 0.02) and larger Grabb-Oakes lines (10.1 mm vs 6.7 mm, p = 0.02), when compared with the patients without any true IONM changes. CONCLUSIONS Intraoperative neuromonitoring may be best utilized for patients who show radiographic features of abnormal skull base morphology, defined as a clival angle < 135° or Grabb-Oakes line > 9 mm. When IONM is employed, SSEP and MEP monitoring are the most useful modalities.

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“…O mercado nacional apresenta muita informação, são aproximadamente mil e quinhentos fármacos e mais de seis mil marcas, que correspondem a quinze mil apresentações comerciais. Assim é dependente do banco de dados informatizado, para que os profissionais não cometam erros relacionados com os medicamentos [24].…”

Section: Rc: 43201unclassified

Erros médicos nas prescrições de medicações

Savian¹,

Fraga²,

Fraga³

2020

Revista Científica Multidisciplinar Núcleo do Conhecimento

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O erro médico ocorre quando um profissional de saúde escolhe um método inadequado de cuidado ou, de forma inadequada executa um método correto. São frequentemente descritos como erros humanos na área da saúde. No entanto, as definições de erro médico estão sujeitas a debate, pois existem muitos tipos de erros médicos, de menor para maior gravidade, e a causalidade é muitas vezes mal determinada. O objetivo deste estudo de revisão foi desmistificar os erros médicos,

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Basilar Invagination: A Craniocervical Kyphosis

Cited by 28 publications

References 13 publications

Clival canal Angle and Basal Angle in Nepalese Population- A Computed Tomography Based Study

Clival canal Angle and Basal Angle in Nepalese Population- A Computed Tomography Based Study

Intraoperative neuromonitoring for pediatric Chiari decompression: when is it useful?

Erros médicos nas prescrições de medicações

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