World Neurosurg
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In patients with supratentorial spontaneous intracerebral hemorrhage, intrahematomal catheter placement may allow for intraclot thrombolysis and drainage. Robotic assistance may be used for the stereotactic placement of catheters. ⋯ Frameless image-guided placement of intraparenchymal hematoma catheter using Robotic Stereotactic Assistance is safe and efficient.
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Quantitative measurements of intracranial vessel walls are reliable in 3-T high-resolution magnetic resonance imaging (HR-MRI). However, few reports have assessed the arterial wall after endovascular treatment (EVT) by 3-T HR-MRI. This study aimed to quantitatively analyze vessel walls in vertebrobasilar artery dissecting aneurysms after EVT. ⋯ Persistent high signal intensity of IMHs in VBDAs after reconstructive EVT may be associated with the progression of VBDAs. It may also indicate an unsteady state of the aneurysm, which suggests that reconstruction of the parent artery is not satisfactory.
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Burst fractures involve the anterior and middle columns with an intact posterior column. Deforming forces are magnified at areas of transition, making the thoracolumbar junction highly susceptible to injury. ⋯ Anterior corpectomy with an expandable titanium cage and lateral rod fixation is safe and effective with minimal complications. It is a viable alternative to posterior decompression and instrumentation.
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To analyze the positive predictive value of large artery occlusion and clinical prognosis in acute ischemic stroke patients with total anterior circulation infarct (TACI) who underwent endovascular treatment in the absence of multimodal CT angiography or CT perfusion. ⋯ In the absence of multimodal CT, endovascular treatment might be beneficial to patients with TACI acute ischemic stroke within 4.5 hours of stroke onset, who had NIHSS score of 8 or greater and ASPECTS of 6 or greater. These inclusion criteria have a high positive predictive value for anterior circulation large artery occlusion.
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Case Reports
First report of renal cell carcinoma metastasizing to the clivus in a paediatric patient.
The clivus is a rare site of tumor occurrence in general, and metastases to this site are especially rare. Renal cell carcinoma is an uncommon entity in the pediatric population. Although not infrequent in adults, when it does occur, metastases to the clivus are extremely uncommon, only having been reported 3 times in the literature. All of these cases involved adults in their sixth decade. ⋯ This article reports for the first time in the literature the spread of a translocation renal cell carcinoma to the clivus in a young child. This serves to alert practitioners to this possibility when faced with a similar scenario.