Neurosurgery
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No prior reports have focused on the natural history and long-term outcomes of intramedullary spinal cord cavernous malformations (ISCCMs) in children. ⋯ The annual overt hemorrhage rate and rehemorrhage rate of ISCCMs were higher in affected children than in affected adults. Surgical resection of pediatric ISCCMs remains the preferred therapeutic option and provides favorable outcomes.
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Observational Study
Failed Foramen Magnum Decompression in Chiari I Malformation Is Associated With Failure to Restore Normal Intracranial Compliance: An Observational Cohort Study.
The standard treatment for symptomatic Chiari malformation (CM) I is foramen magnum decompression (FMD) to facilitate cerebral spinal fluid flow through the foramen magnum, improve intracranial compliance, and alleviate symptoms (commonly headache). This procedure has a variable success rate, with a significant proportion of patients having persistent symptoms after surgery. ⋯ In this cohort, patients with persistent symptoms after FMD have persistently impaired intracranial compliance, similar to patients who have not undergone surgery at all when compared with a control group. The reasons for this are not clear, and further research is required to establish the causation and optimum management for failed FMD.
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Thin-walled regions (TWRs) of aneurysm surfaces observed in microscopic surgery are thought to be vulnerable areas for growth and rupture of unruptured intracranial aneurysms (UIAs). ⋯ WSSD, a hemodynamic parameter that accounts for both magnitude and directionality of WSS, showed the highest correspondence. High WSSD might correspond with TWR of intracranial aneurysms, which are likely high-risk areas for rupture.