World Neurosurg
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Positional compression of the vertebral artery (VA) owing to cervical spondylosis is an uncommon cause of stroke. We report two cases of cervical spondylosis causing wake-up stroke, which is extremely rare. ⋯ Magnetic resonance angiography of extracranial cervical VAs may be useful as an initial screening test for VA compression secondary to cervical spondylosis as a rare cause of wake-up stroke, especially in cases of cerebral infarction in the posterior circulation with no evidences of causative arrhythmia and intracranial lesions.
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Stereotactic radiosurgery (SRS) alone is an attractive option for treatment of brain metastases. SRS avoids whole-brain radiotherapy (WBRT)-associated morbidity, but is limited by regional central nervous system (CNS) failures and short survival in some patients. We evaluated a subgroup of patients with controlled systemic disease that could represent a favorable patient population for SRS alone. ⋯ Patients with brain metastases after 1 year or longer of primary and systemic disease control represent a particularly favorable cohort, with lower regional CNS failure and prolonged survival, for an approach of SRS alone.
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Objectives of this study were to identify and compare symptom clusters in patients with meningioma and glioma and to assess and compare predictors of quality of life (QoL) in both patient groups. ⋯ In this study, the type and composition of symptom clusters differed between patients with meningioma and glioma. Our data also provide evidence that even when participants reported mild symptoms, these clusters could be used to predict QoL in patients with meningioma and glioma.
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Case Reports
Geographically Remote Cerebral Venous Sinus Thrombosis in Patients with Intracranial Tumors.
Cerebral venous sinus thrombosis (CVST) related to intracranial tumors has most commonly been recognized as an operative complication related to local operative factors such as retraction or direct venous injury. CVST may also be caused by tumor-related factors such as local mass effect but rarely occurs geographically remote from the site of the tumor. ⋯ In 3 cases CVST was noted at the time of resection, and 3 cases occurred in a delayed fashion. Each case is discussed in detail, and the utility of intraoperative magnetic resonance imaging in the early diagnosis of this complication is highlighted.
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Comparative Study
Surgical Resection of Insular Gliomas and the Role of Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging Tractography - Single Surgeon Experience.
In gliomas located in proximity to eloquent areas, near total resection and subsequent radiotherapy is often preferred to avoid postoperative neurologic complications. Preoperative functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) tractography provide new insights into surgeries of insular gliomas. In this study we report our experience of surgical management of insular gliomas and the role of fMRI and DTI tractography in planning the resection. ⋯ Surgical resection of insular gliomas remains a challenge to the neurosurgeon and demands good knowledge of anatomic landmarks. Use of fMRI and DTI tractography may help achieve a good outcome.