Neurosurgery
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The Chiari I malformation is a rare disorder characterized by downward herniation of the brainstem and cerebellar tonsils through the foramen magnum. Many individuals with the Chiari I malformation do not become symptomatic until adulthood, and the factors that contribute to the onset of symptoms have not been well characterized. The purpose of this systematic chart review was to determine the incidence and validity of minor head or neck trauma as precipitating factors for the onset of symptomatic Chiari I malformation. ⋯ Minor head or neck trauma can precipitate the onset of symptoms in a small number of previously asymptomatic patients with Chiari I malformation. Health care professionals must be aware that neurological symptoms that persist or worsen after minor head or neck trauma could indicate an underlying Chiari I malformation.
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Case Reports
Surgical management of a paraclinoid aneurysm containing a displaced neuroform microstent: technical case report.
We report the first case of clip obliteration of a cerebral aneurysm containing a displaced microstent. ⋯ The patient experienced an excellent clinical and angiographic outcome. Although not the ideal treatment strategy, this report illustrates that clip obliteration of aneurysms containing displaced microstents can be performed successfully for this complication of endovascular treatment.
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In this case report, we present a patient with normal pressure hydrocephalus in whom a lumbar drainage trial yielded a false-negative result secondary to cervical spondylosis. ⋯ This case report illustrates how altered cerebrospinal fluid flow dynamics may impact the accuracy of the lumbar spinal drainage trial in patients with normal pressure hydrocephalus.
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We sought to assess the appearance of cerebral cavernous malformations (CCM) on magnetic resonance imaging (MRI) scans in murine Ccm1 and Ccm2 gene knockout models and to develop a technique of lesion localization for correlative pathobiological studies ⋯ The high-field MRI techniques offer new opportunities for further investigation of disease pathogenesis in vivo, and the localization, staging, and histobiological dissection of lesions, including the presumed earliest stages of CCM lesion development.
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It remains unknown whether the extent of surgical resection affects survival or disease progression in patients with supratentorial low-grade gliomas. ⋯ GTR was associated with a delay in tumor progression and malignant degeneration as well as improved OS independent of age, degree of disability, histological subtype, or revision versus primary resection. GTR should be safely attempted when not limited by eloquent cortex.