World Neurosurg
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Choroid plexus papilloma (CPP) in the third ventricle is a rare benign intracranial tumor. ⋯ Young children have a small total blood volume and fragile cardiovascular status. Therefore, it is critical to preserve the venous system and to ligate the feeding artery before extirpation of the tumor. The surgical approach to the third ventricular CPPs should be tailored to individual children based on tumor size, location, and vascularity.
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In the treatment of craniopharyngioma, complete surgical removal offers the best chance of cure and recurrence prevention. The basal interhemispheric approach involves problems with difficulty resecting tumors in the retrochiasmatic space located behind the optic chiasm and inability to resect, under direct view, tumors extending into the sella turcica. We report our approach via the sphenoid sinus devised to resolve these problems. ⋯ This approach allowed a working space to be secured even in cases with a narrow prechiasmatic space, allowing tumor freeing from the lower plane of the optic nerve and safe resection of the intrasellar tumor.
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To determine whether various clinical factors are related to long-term outcomes of patients with sporadic cerebellar hemangioblastomas. ⋯ The solid configuration observed on preoperative images of sporadic cerebellar hemangioblastomas is one of the most important clinical factors related to both immediate and long-term outcomes after surgery.
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Lateral ventricular trigone meningioma is relatively rare and surgical resection is the main treatment strategy. It is a challenge to achieve total resection without any complication. We analyzed a series of cases using literature review. ⋯ Surgical resection, using the trans-sulcal approach with intraoperative ultrasound assistance, can achieve a high rate of total resection and a low rate of complication, promising a good prognosis. The management technique and the perioperative treatment have to be individualized.
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Distal posterior inferior cerebellar artery aneurysms: clinical features and outcome of 80 patients.
Aneurysms of the posterior inferior cerebellar artery (PICA) distal to its origin are rare. Beside their rarity, their treatment is challenged by a high proportion of fusiform aneurysms, torturous course of PICA, and often severe bleeding. Our aim is to represent the characteristics of these aneurysms and their treatment, as well as to analyze outcome. ⋯ Microsurgery is a feasible treatment for distal PICA aneurysms. Despite the challenge of often severe hemorrhage, wide-necked aneurysms, and some risk for laryngeal palsy, most patients surviving the initial stage return to normal life. Because of the greater number of rebleedings than for aneurysms at other locations, immediate treatment is crucial.