Neurosurgery
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Patients with convexity and parasagittal (CPS) meningiomas treated with stereotactic radiosurgery (SRS) have been shown to be at risk for posttreatment symptomatic peritumoral edema (SPTE). We sought to analyze the pattern of this complication and compare it with the SPTE experienced in our patients treated with fractionated stereotactic radiotherapy. ⋯ Despite larger lesion volumes, fractionated stereotactic radiotherapy is associated with less risk of posttreatment SPTE than SRS for patients with CPS meningiomas in our series. For patients treated with SRS, smaller volume and dose <14 Gy seems to be safe. Longer follow-up will be required to compare late complications and tumor control rates in these patients.
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In rare cases, space-occupying pseudoarthrotic clavicular nonunion causes symptomatic brachial plexus compression. The surgical treatment of clavicular pseudoarthrosis has been extensively reported in the literature. This article reports our experience of a definitive treatment strategy using free vascularized fibula flaps in cases of persistent compression of the brachial plexus by relapsing bony nonunion mass lesions. ⋯ Recurrent space-occupying pseudoarthrosis of the clavicle complicated with neurovascular compression might warrant definitive reconstruction using a free vascularized bone flap.
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The Sophysa Pressio (Sophysa Ltd., Orsay, France) is a new intracranial pressure monitoring system. This study aimed to evaluate its accuracy and compare it with the popular Codman intracranial pressure transducer (Codman/Johnson & Johnson, Raynham, MA) in vitro. ⋯ The new Pressio transducer proved to be accurate for measuring static and dynamic pressure during in vitro evaluation.
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The cases of two patients who presented with sylvian aqueductal obstruction caused by venous lesions (an ectatic vein and a developmental venous anomaly, which are uncommon causes of obstructive hydrocephalus) are reported. ⋯ Venous anomalies may cause obstructive hydrocephalus and can be suspected in cases of chronic and intermittent headaches. Endoscopic third ventriculostomy is an effective treatment.
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Comparative Study
Prognostic factors for radiosurgery treatment of trigeminal neuralgia.
Trigeminal neuralgia treatment results are thought to be highly dependent upon selection criteria. We retrospectively analyzed a series of patients to determine the likelihood of treatment success for patients treated with radiosurgery. ⋯ Anticonvulsant responsiveness is the single most important prognostic indicator of treatment success for patients presenting with facial pain. Other predictive factors generally failed to reach statistical significance. Linear accelerator radiosurgery for trigeminal neuralgia is a safe and effective treatment for well-selected patients, with results similar to those obtained with gamma unit radiosurgery.