World Neurosurg
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Review Case Reports
Intraparenchymal meningioma: clinical, radiological, and histological review.
Although meningiomas are usually attached to the dura matter, intraparenchymal and subcortical meningiomas do not show dural attachment. ⋯ Because of the unique features described earlier, which contrast with those of ordinary meningiomas, there is a possibility that intraparenchymal meningiomas are not precisely diagnosed. Collectively, the information collected from the study cases may facilitate the appropriate management of these rare tumors.
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Review Case Reports
Usefulness of embolization for iatrogenic dural arteriovenous fistula associated with recurrent chronic subdural hematoma: A case report and literature review.
Refractory chronic subdural hematomas due to iatrogenic dural arteriovenous fistulas (dAVFs) are difficult to treat. We report our experience and propose a guideline on basis of a literature review for the usefulness of embolization of middle meningeal artery (MMA) for the treatment of the same. ⋯ Refractory chronic subdural hematoma with reaccumulation within a short interval should be subjected to digital subtraction angiography of the MMA. Embolization of ipsilateral MMA is safe, effective, and a useful option for the treatment of iatrogenic dAVF and resolution of hematoma.
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The presigmoid approach can be used to treat vertebrobasilar artery aneurysms when circumstances require more operative exposure. High morbidity and mortality in these cases have been reported. In this study, we describe our modified presigmoid approach for vertebrobasilar artery aneurysms and our clinical results. ⋯ We have described our experiences of using the presigmoid approach to treat vertebrobasilar aneurysms. The clinical and radiographic results are acceptable given the complex location and configuration of the treated aneurysms. Unfavorable outcomes are related to the poor admission Hunt and Hess grade, aneurysm morphology, and aneurysm size.
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Randomized Controlled Trial
Opening the Internal Hematoma Membrane does not Alter the Recurrence Rate of Chronic Subdural Hematomas - A Prospective Randomized Trial.
Factors determining the recurrence of chronic subdural hematomas (CSDHs) are not clear. Whether opening the so-called internal hematoma membrane is useful has not been investigated. ⋯ Opening the internal hematoma membrane does not alter the rate of patients requiring revision surgery and the number of patients showing a marked residual hematoma 6 weeks after evacuation of a CSDH.
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There are no established treatment strategies for aneurysms that recur after clipping. In this study, we present cases of patients who experienced recurrent aneurysms after clipping and subsequently underwent surgical intervention. ⋯ In our experience, coil embolization is a safe and effective procedure for treating recurrent aneurysms. When cases are unsuitable for coil embolization, surgical treatment often requires neurosurgeons not only to overcome the general technical difficulty of reoperative clipping but also to perform challenging vascular reconstruction.