Computerised modified paramedian approach technique versus conventional midline approach technique of lumbar puncture: a randomised control trial protocol.

INTRODUCTION: The lumbar puncture (LP) technique is widely used for diagnostic and therapeutic purposes. In recent years, the paramedian approach technique (PAT) has gained increasing interest due to its advantages over the conventional midline approach technique (MAT) that has been traditionally employed in clinical practice for LP. However, there have been inconsistent discussions regarding the efficacy of different LP techniques. Based on digital virtual human and computer simulation techniques, a new approach called computerised modified PAT (CMPAT) was proposed. Therefore, the aim of this study is to discuss a randomised controlled trial (RCT) protocol to investigate and compare the effects of CMPAT and MAT in patients undergoing LP. METHODS AND ANALYSIS: We will conduct a prospective, multicentre RCT. The study will recruit 84 patients aged 18-99 years who require LP. Participants will be randomly assigned to either the CMPAT treatment group (group A) or the MAT treatment group (group B). The primary outcome measure will be the number of needle insertion attempts required for a successful LP. Secondary outcomes will include the puncture success rate, pain assessment in the back, head, and legs, and the occurrence of complications. The measurement of these secondary outcomes will be taken during the procedure, as well as at specific time points: 30 min, 6 hours, 1 day, 3 days, 7 days, 2 weeks and 4 weeks after the procedure. Pain levels will be assessed using a Numerical Rating Scale. ETHICS AND DISSEMINATION: Ethical approval (2022YF052-01) has been obtained from the Ethics Committee of Fujian Medical University Union Hospital, Fuzhou, China. The research findings will be published in an international peer-reviewed scientific journal and presented at scientific conferences. TRIAL REGISTRATION NUMBER: ChiCTR2300067937.

Spatiotemporal distribution and evolution pattern of Chinese Go League clubs in 20 years of professionalism.

Over the course of 20 years, from 1999 to 2018, the Chinese Go League has gradually developed and flourished, becoming a significant part of urban sports culture. Using mathematical statistics, spatiotemporal trajectory, and geospatial analysis, this research investigates the spatiotemporal distribution pattern and diffusive evolution characteristics of Chinese Go League clubs from the perspective of sports geography. The results of this study show that the following: (1) Over the past 20 years, the number of Chinese Go League clubs has increased in a "stepped" pattern, and there is still plenty of room for expansion. (2) Chinese Go League clubs are primarily located in municipalities directly under the central government and provincial capital cities (accounting for 82.6% of the total), with the Bohai Rim, Yangtze River Delta, and Southwest region of China forming a spatial pattern. (3) Host cities of Chinese Go League clubs are generally discrete, with clustering and random distribution occurring only seldom. The spatial distribution also tends to favor southern cities. (4) Chinese Go League clubs frequently change their names and host cities, and they have a variety of links with those cities, which primarily includes urban stability, urban transition, and urban fluctuation. In future, the professionalization and sustainable development of Chinese Go industry can be enhanced by the marketability of Chinese Go clubs, developing new markets for Chinese Go, and building a healthy development model with multiple linkages of Chinese Go clubs, sponsors, and host cities.

Brain metastasis from colorectal cancer: Treatment, survival, and prognosis.

To investigate the clinical characteristics, survival, prognostic factors, and treatment of brain metastasis (BM) from colorectal cancer (CRC). Twenty-one patients with BM from CRC were retrospectively reviewed. Predictive factors for BM and prognostic factors after the diagnosis of BM were examined by univariate and multivariate COX analysis. The time from the development of extracranial metastases, including lung, bone, and liver, to the occurrence of BM was recorded separately. The median overall survival time was 7 months. In univariate prognostic analysis, median survival with multimodal therapy was better than that with unimodal therapy (10 months vs 3 months, P = .000). In addition, median survival with Karnofsky performance status (KPS) < 70, 1 BM lesion, primary tumor stage of II-III, extracranial lesions < 2, and no extracranial metastasis were much better than the other groups (P < .05 of all). Although there was not a significant difference in median survival between patients receiving combination treatment with bevacizumab and those who did not, treatment with bevacizumab was associated with better survival (10 months vs 5 months, P = .436). The time intervals from bone, liver, and lung metastases to BM were 3, 6.5, and 11 months, respectively. Based on multivariate Cox analysis, KPS and treatment modalities were independent prognosis factors (P = .039 and P = .000, respectively). CRC patients with a high KPS and multimodal treatment have improved survival.

Altered Resting State Networks Before and After Temporal Lobe Epilepsy Surgery.

OBJECTIVES: To explore the resting state networks (RSNs) alterations in patients with unilateral mesial temporal lobe epilepsy (mTLE) before and after successful surgery. METHODS: Resting-state functional MRI and T1-weighted structural MRI were obtained in 37 mTLE patients who achieved seizure freedom after anterior temporal lobectomy. Patients were scanned before surgery and at two years after surgery. Twenty-eight age- and sex-matched healthy controls were scanned once. Functional connectivity (FC) changes within and between ten common RSNs before and after surgery, and FC changes between hippocampus and RSNs were explored. RESULTS: Before surgery, decreased FC was found within visual network and basal ganglia network, while after surgery, FC within basal ganglia network further decreased but FC within sensorimotor network and dorsal attention network increased. Before surgery, between-network FC related to basal ganglia network, visual network and dorsal attention network decreased, while between-network FC related to default mode network increased. After surgery, between-network FC related to visual network and dorsal attention network significantly increased. In addition, before surgery, ipsilateral hippocampus showed decreased FC with visual network, basal ganglia network, sensorimotor network, default mode network and frontoparietal network, while contralateral rostral hippocampus showed increased FC with salience network. After surgery, no obvious FC changes were found between contralateral hippocampus and these RSNs. CONCLUSION: MTLE patients showed significant RSNs alterations before and after surgery. Basal ganglia network showed progressive decline in functional connectivity. Successful surgery may lead to RSNs reorganization. These results provide preliminary evidence for postoperative functional remodeling at whole-brain-network level.

Culprit vascular patterns and surgical outcomes of hemifacial spasm caused by an AICA segment passing between cranial nerve VII and VIII: A series of 25 cases.

OBJECTIVE: To report the vascular anatomic characteristics and surgical outcomes of hemifacial spasm (HFS) caused by an anterior inferior cerebellar artery (AICA) segment passing between cranial nerve VII (CN VII) and cranial nerve VIII (CN VIII). PATIENTS AND METHODS: This case series study retrospectively reviewed records of 1040 consecutive patients treated with MVD for HFS in our hospital in 10 years. 25 patients had the culprit vessel recorded as an AICA segment passing between CN VII and CN VIII. Vascular anatomic characteristics were reviewed from intraoperative microscopic videos. The clinical outcomes were followed up at 3-month and 1-year time points. RESULTS: The culprit AICA segments feature 3 discrete anatomic patterns. The patterns denoted as pattern A, B, and C were identified in 19(76%), 3(12%), and 3 (12%) of the 25 patients respectively. Postoperative spasm relief were achieved in 19(76%), 22(88%), and 23 (92%) of the patients at immediately after surgery, 3-month, and 1-year follow-up respectively. 3(12%) of them have permanent postoperative cranial nerve deficits, including one patient with hearing loss and 2 patients with vocal cord palsy. CONCLUSIONS: Though an AICA segment passing between CN VII and CN VIII is common, very rarely it was deemed the culprit for HFS in our patients. We used fREZ centered definition and operation. We found the culprit AICA segments feature 3 discrete anatomic patterns. We observed good spasm relief outcome and relatively fewer complications with CN VII and CN VIII. Identifying the 3 anatomic patterns may help with a smooth decision-making when vascular compression by an AICA segment passing between CN VII and CN VIII is suspected.

Structural and functional reorganization of contralateral hippocampus after temporal lobe epilepsy surgery.

OBJECTIVE: To explore the structural and functional reorganization of contralateral hippocampus in patients with unilateral mesial temporal lobe epilepsy (mTLE) who achieved seizure-freedom after anterior temporal lobectomy (ATL). METHODS: We obtained high-resolution structural MRI and resting-state functional MRI data in 28 unilateral mTLE patients and 29 healthy controls. Patients were scanned before and three and 24 months after surgery while controls were scanned only once. Hippocampal gray matter volume (GMV) and functional connectivity (FC) were assessed. RESULTS: No obvious GMV changes were observed in contralateral hippocampus before and after successful surgery. Before surgery, ipsilateral hippocampus showed increased FC with ipsilateral insula (INS) and temporoparietal junction (TPJ), but decreased FC with widespread bilateral regions, as well as contralateral hippocampus. After successful ATL, contralateral hippocampus showed: (1) decreased FC with ipsilateral INS at three months follow-up, without further changes; (2) decreased FC with ipsilateral TPJ, postcentral gyrus and rolandic operculum at three months, with an obvious increase at 24 months follow-up; (3) increased FC with bilateral medial prefrontal cortex (MPFC) and superior frontal gyrus (SFG) at three months follow-up, without further changes. CONCLUSIONS: Successful ATL may not lead to an obvious structural reorganization in contralateral hippocampus. Surgical manipulation may lead to a transient FC reduction of contralateral hippocampus. Increased FC between contralateral hippocampus and bilateral MPFC and SFG may be related to postoperative functional remodeling.

Repeat microvascular decompression for patients with persistent or recurrent trigeminal neuralgia: Prognostic factors and long-term outcomes.

Patients with persistent or recurrent trigeminal neuralgia (TN) after microvascular decompression (MVD) are frequently difficult to manage. This study aimed to analyze the safety and efficiency of repeat MVD, with the main focus on prognostic factors and long-term outcomes.We performed a retrospective study of 41 TN patients (19 men, 22 women) who underwent repeat MVD due to persistent or recurrent pain from January 2008 to January 2016. These patients were followed up from 12 to 96 months (mean, 42 ±â€Š17.3 months). Univariate analysis by Spearman's rank correlation coefficient was used for analysis of prognostic factors.During the repeat MVD, compression of the trigeminal nerve was noted by an artery in 15 patients (36.6%), vein in 6 patients (14.6%), Teflon in 8 patients (19.5%), and no compression in 12 patients (29.3%). Twenty-one patients (51.2%) had already undergone 1 or more previous ablative procedures, either before the first MVD or between the surgeries. The complete pain relief rates of repeat MVD were 87.8% immediately after surgery and 75% at last follow-up. Thirteen patients (31.7%) had new or increased facial numbness after repeat surgery. Univariate analysis revealed 2 prognostic factors, negative finding during reoperation (P = .021) and no pain relief after the initial surgery (P = .038), that showed a negative influence on success rates after repeat MVD.Repeat MVD can still achieve an excellent outcome in patients with persistent or recurrent pain. However, the risk of facial numbness is increased. Surgeons should be selective in performing repeat MVD, priority should be given to patients who have a pain-free interval after initial MVD or show demonstrable compression on imaging studies.

The experience of the multidisciplinary team in epilepsy management from a resource-limited country.

OBJECTIVE: The use of multidisciplinary teams (MDTs) is a global trend in disease management, while China is still at the exploratory stage MDTs. We aimed to summarize our experience and assess the impact of MDT use in managing patients with epilepsy and optimizing their seizure outcomes. METHODS: Our MDT is staffed with skilled epileptologists, electroencephalography experts, neurosurgeons, child neurologists, radiologists, and psychiatrists. The MDT discussion has been carried out once or twice a week since 2013. We reviewed our consecutive patients discussed at our MDT from March 2013 to December 2017. The detailed clinical characteristics, suggestions, and follow-up data were collected and analyzed. RESULTS: A total of 1088 patients (604 male, 484 female) were included in this study. The median age at MDT discussion was 21 years (range 10 months to 79 years). Three hundred eighty-seven patients (35.6%) were younger than18 years of age. The median age at seizure onset was 12 years (range 2 days to 77 years). Most patients (80.4%) had at least one seizure per month and most (77%) took 2 or more antiepileptic drugs. A total of 70.6% of patients reached the standard of drug-resistant epilepsy and 74.2% of brain magnetic resonance imaging (MRI) studies detected positive findings. After detailed MDT discussion, 18 patients were diagnosed as having nonepileptic diseases, including psychogenic nonepileptic seizure, syncope, sleep disorder, paroxysmal kinesigenic dyskinesia, withdrawal symptom, and cerebral palsy. Three hundred eighty-two patients (35.1%) were suitable for resective surgery. Among the postoperative patients successfully followed up for more than 1 year, 72.7% (136/187) received favorable outcomes (Engel class I). The seizure-free rate was 78.6% after temporal lobe surgery and 58.9% after extratemporal surgery. SIGNIFICANCE: Epilepsy management can be optimized through MDT discussion to attain accurate diagnosis and favorable seizure outcomes. There is still room for MDT improvement in resource-limited countries.

Rapid, experience-dependent translation of neurogranin enables memory encoding.

Experience induces de novo protein synthesis in the brain and protein synthesis is required for long-term memory. It is important to define the critical temporal window of protein synthesis and identify newly synthesized proteins required for memory formation. Using a behavioral paradigm that temporally separates the contextual exposure from the association with fear, we found that protein synthesis during the transient window of context exposure is required for contextual memory formation. Among an array of putative activity-dependent translational neuronal targets tested, we identified one candidate, a schizophrenia-associated candidate mRNA, neurogranin (Ng, encoded by the Nrgn gene) responding to novel-context exposure. The Ng mRNA was recruited to the actively translating mRNA pool upon novel-context exposure, and its protein levels were rapidly increased in the hippocampus. By specifically blocking activity-dependent translation of Ng using virus-mediated molecular perturbation, we show that experience-dependent translation of Ng in the hippocampus is required for contextual memory formation. We further interrogated the molecular mechanism underlying the experience-dependent translation of Ng, and found that fragile-X mental retardation protein (FMRP) interacts with the 3'UTR of the Nrgn mRNA and is required for activity-dependent translation of Ng in the synaptic compartment and contextual memory formation. Our results reveal that FMRP-mediated, experience-dependent, rapid enhancement of Ng translation in the hippocampus during the memory acquisition enables durable context memory encoding.

Risk Factors Analyses for Seizure Recurrence in Different Periods After Refractory Epilepsy Surgery: A Prospective Single-Center Study.

OBJECTIVE: To evaluate the potential risk factors associated with seizure recurrence in different periods after epilepsy surgery. METHODS: A total of 303 patients with refractory epilepsy after epilepsy surgery were included. The Kaplan-Meier method with log-rank test and univariate and multivariate Cox proportional hazards model were performed to calculate the comparison of survival curves between groups and identify the risk factors associated with seizure recurrence in different periods after surgery. RESULTS: The significant predictors of seizure recurrence were determined, including duration of epilepsy (P = 0.018), seizure types (P = 0.009), magnetic resonance imaging findings (P = 0.007), intracranial electroencephalographic recordings (P = 0.002), sides of epileptogenic zone (P = 0.025), and types of surgery (P = 0.002). Moreover, the significant predictors of seizure recurrence within 12 months after surgery were also included, such as gender (P = 0.007), duration of epilepsy (P = 0.013), intracranial electroencephalographic recordings (P = 0.003), and types of surgery (P < 0.001). Our results indicated that the variables of magnetic resonance imaging findings (P = 0.015), sides of epileptogenic zone (P = 0.004), and seizure relapse within 12 months after surgery (P < 0.001) were significantly associated with seizure recurrence in 12-36 months after surgery. Seizure relapse within 12 months after surgery (P < 0.001) was also associated with seizure recurrence >36 months after surgery. CONCLUSIONS: We reconfirmed the well-known risk factors associated with seizure recurrence and also identified the controversial variables. In addition, we found that the risk factors associated with seizure recurrence were different in different periods after epilepsy surgery.

Primary trigeminal neuralgia is associated with posterior fossa crowdedness: A prospective case-control study.

Neurovascular conflict (NVC) has been postulated to be the underlying cause of trigeminal neuralgia (TN). Does the posterior fossa crowdedness increase the chance of NVC? The aim of this study was to quantitatively measure the posterior fossa crowdedness in patients with TN and to perform a comparison with healthy controls. We conducted a prospective case-control study of 46 patients diagnosed with primary TN and 46 sex- and age-matched healthy controls. All subjects underwent high-resolution three-dimensional MRI, and the 3D Slicer software was used to measure the posterior fossa volume (PFV) and hindbrain volume (HBV). The posterior fossa crowdedness index (PFCI) was calculated as HBV/PFV × 100%. The results showed that patients with TN had a larger HBV (155.4 ±â€¯23.2 cm3 versus 152.9 ±â€¯13.5 cm3, P = .16) and a smaller PFV (182.7 ±â€¯18.3 cm3 versus 186.1 ±â€¯11.7 cm3, P = .42) as compared to control subjects, but these values were not significantly different. The mean PFCI was significantly higher in patients with TN than in controls (85.1% ±â€¯3.4% versus 82.2% ±â€¯5.3%; P = .03). Women had a more crowded posterior fossa than men (85.8% ±â€¯2.1% versus 84.1% ±â€¯2.6%; P = .023) in patients with TN. The correlation analysis showed that a higher PFCI was associated with younger age (P = .02), woman (P = .014), and TN disease (P = .001). From this study, we conclude that patients with TN have a more crowded posterior fossa than healthy subjects. Women, younger age and TN disease are associated with a higher PFCI. The posterior fossa crowdedness may be a risk factor of NVC, and thus more likely to result in the genesis of TN.

MicroRNA-485 inhibits malignant biological behaviour of glioblastoma cells by directly targeting PAK4.

Glioblastoma (GBM), which is characterised by rapid growth, cellular heterogeneity, angiogenesis, extensive invasion, hypoxia and necrosis, is the most common histological subtype of glioma in adults. MicroRNA (miRNA) dysregulation is a common feature of human cancers, including GBM. Previous studies have suggested that miRNAs are a novel class of regulatory molecules in various human cancers. Therefore, miRNAs may be investigated as a novel candidate and screening tool in the clinical diagnosis, therapy and prognosis of GBM. Recent accumulating evidence has demonstrated that miRNA­485 (miR­485) is involved in the development and progression of several types of human cancers. However, the expression level, exact role and underlying mechanisms of miR­485 in GBM remain unclear. In this study, miR­485 was downregulated in both GBM tissue specimens and cell lines. miR­485 overexpression inhibited GBM cell proliferation, colony formation, migration and invasion; increased apoptosis in vitro; and reduced tumour growth in vivo. In addition, p21­activated kinase 4 (PAK4) was demonstrated to be a direct and functional target of miR­485 in GBM. Furthermore, PAK4 was upregulated in GBM tissues and negatively correlated with miR­485 expression. Moreover, PAK4 knockdown exhibited a similar effect to miR­485 overexpression in GBM cells. Enforced expression of PAK4 rescued miR­485 tumour­suppressor functions in GBM cells. miR­485 inhibited the activation of the AKT and ERK signalling pathways in GBM. These results indicate that miR­485 acts as a tumour suppressor in GBM by, at least partially, directly targeting PAK4 and regulating the AKT and ERK signalling pathways. Thus, miR­485 may be a potential target for the treatment of patients with GBM.

Microvascular decompression for trigeminal neuralgia in patients with failed gamma knife surgery: Analysis of efficacy and safety.

OBJECTIVE: Though it is usually successful, failure or delayed pain recurrence may occur after gamma knife surgery (GKS) in patients with trigeminal neuralgia (TN), and additional intervention may be required. This study aimed to investigate whether the safety and efficacy of microvascular decompression (MVD) were influenced by prior GKS. PATIENTS AND METHODS: The authors retrospectively evaluated 36 consecutive TN patients who underwent MVD after failed GKS from January 2012 to June 2013. The clinical features, operative findings and surgical outcomes were reviewed and statistically analyzed, and the operation results were further compared with a cohort of 60 patients with no prior GKS. RESULTS: At surgery, atrophy of the trigeminal nerve was observed in 13 patients (36.1%), arachnoid thickening in 6 patients (16.7%), adhesions between vessels and the trigeminal nerve in 8 patients (22.2%), and atherosclerotic plaque in the offending vessels in 3 patients (8.3%). The complete pain relief rates were 83.3% immediately after MVD and 72.2% at last follow-up, which showed no statistical difference when compared with patients without GKS. New or worsened facial numbness occurred in 7 patients (19.4%), which was significantly higher than those without GKS (p=0.02). Univariate analysis suggested that a positive pain response to the prior GKS correlated with better long-term outcome (p=0.015), and the existence of arachnoid adhesions correlated with higher risk of facial numbness (p=0.03). CONCLUSIONS: MVD remains an appropriate and effective alternative therapy for patients with failed GKS, with no added technical difficulty. However, the risk of facial numbness seems to be higher than those with MVD alone.

Effects of microvascular decompression on depression and anxiety in trigeminal neuralgia: A prospective cohort study focused on risk factors and prognosis.

OBJECTIVE: Patients with trigeminal neuralgia (TN) often develop a terrible fear of triggering pain, which may lead to depression and anxiety, exerting a negative effect on their quality of life. This study aimed to investigate the prevalence and risk factors of depression and anxiety in TN patients, and further to investigate the effects of microvascular decompression (MVD) on these psychiatric disorders. PATIENTS AND METHODS: A prospective cohort study was conducted, patients with TN who underwent MVD in our department between 2013 and 2015 were included. Visual analogue scale (VAS) score was used to measure the severity of pain. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used to evaluate depression and anxiety disorders before and 6-month after MVD. The clinical data of these patients were collected prospectively and statistically analyzed. RESULTS: A total of 128 study subjects comprising 70 women and 58 men with a mean age of 47.5±11.2years were included in this study. The mean VAS score was 7.7±1.5. Eighty-three patients (64.8%) had depression and 24 patients (18.8%) suffered anxiety. Multivariate logistic regression analysis revealed that female gender (OR=2.4, P=0.036), high pain intensity (OR=3.25, P=0.027) and ineffective medicine treatment (OR=1.89, P=0.041) were associated with depression, and female gender (OR=3.45, P=0.034) and high pain intensity (OR=2.88, P=0.022) were also associated with anxiety. There were significant improvements in depression and anxiety symptoms between pre- and postoperative responses. CONCLUSIONS: Depression and anxiety are prevalent in patients with idiopathic TN. Female gender, high pain intensity and ineffective medicine treatment are risk factors. MVD not only provides high pain-relief rate, but also leads to significant improvements in the depression and anxiety symptoms.

Surgical Management of Hemifacial Spasm Associated with Chiari I Malformation: Analysis of 28 Cases.

OBJECTIVE: Hemifacial spasm (HFS) associated with Chiari I malformation (CIM) is rare. This study aimed to analyze the frequency of HFS associated with CIM in our department and further to investigate the clinical characteristics, treatment strategies, and outcomes of these cases. METHODS: Twenty-eight of 831 patients with HFS who fulfilled the criteria for CIM were analyzed retrospectively. In this series, microvascular decompression (MVD) was performed in 23 patients (82.1%). The remaining 5 patients (17.9%) with obvious symptoms attributable to CIM were treated only with foramen magnum decompression. The mean follow-up period was 41 ± 21.7 months. RESULTS: The frequency of HFS associated with CIM was 3.4%. There were 19 women (67.9%) and 9 men (32.1%) with a mean age of 36.4 ± 7.5 years. The most common symptoms were headache, paraesthesias, and muscular weakness with the exception of typical HFS. Seventeen patients (73.9%) experienced immediate postoperative spasm relief, and 21 patients (91.3%) were spasm relief at discharge after MVD. However, 3 patients (14.3%) experienced delayed recurrence of HFS after successful MVD in the follow-up. After foramen magnum decompression, 3 of 5 patients experienced complete relief of the spasm, and 4 patients showed improvement in the CIM-related symptoms. CONCLUSIONS: The results suggest that MVD can still be an effective treatment for HFS when it coexists with CIM. Furthermore, posterior fossa crowdedness may be a common risk factor for the 2 diseases, and foramen magnum decompression should be considered as the primary procedure in patients with HFS and symptomatic CIM.

Improvement of Quality of Life in Patients with Hemifacial Spasm After Microvascular Decompression: A Prospective Study.

OBJECTIVE: Although not life threatening, hemifacial spasm (HFS) can be disabling and significantly affect quality of life (QOL). The aim of this study was to assess the major factors affecting the QOL and further to investigate the impact of microvascular decompression (MVD) on QOL in patients with HFS. METHODS: Patients with HFS who underwent MVD in our department between 2013 and 2014 were included in this study. The validated, disease-specific questionnaire (HFS-30) was used to evaluate the QOL in patients with HFS before surgery and 1 year after MVD. The clinical data of these patients were collected prospectively and statistically analyzed. RESULTS: A total of 116 consecutive patients were enrolled in this study, including 69 women and 47 men, with a mean age of 43.3 ± 7.8 years. The global QOL was significantly impaired in patients with HFS. There was a positive correlation of severity of HFS with patient's QOL both in physical and mental health domains (r = 0.34, P = 0.02; r = 0.46, P = 0.03). Patients with a higher educational level tended to have a worse QOL in the mental health domain (r = 0.43, P = 0.02). Seventy-nine patients (68.1%) were spasm free immediately postoperatively, 106 (91.4%) were spasm free at 1-year follow-up. There were significant improvements across all subscales of the HFS-30 questionnaire between preoperative and postoperative responses, and 84.5% of patients experienced significant improvement in QOL after MVD. CONCLUSIONS: HFS affects QOL both physically and mentally. Patients with severe HFS symptoms or a higher educational level are at higher risk of worse QOL. MVD not only provides high spasm-relief rate but also leads to significantly higher QOL after surgery.

Intramedullary Spinal Cord Metastasis from Ovarian Cancer in a 50-Year-Old Female.

Intramedullary spinal cord metastasis (ISCM) from ovarian cancer is rare. Here we report a case of a 50-year-old female with ISCM from ovarian cancer.