World Neurosurg
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Even although microvascular decompression is the standard treatment for hemifacial spasm (HFS), the treatment is not always 100% successful. Some patients experience the reappearance of HFS after temporary relief after surgery. We analyzed our data to elucidate the reasons for and prognosis of HFS reappearance, specifically focusing on exact compressive location of the facial nerve. ⋯ After microvascular decompression for HFS, almost half of the patients experienced transient HFS recurrence despite sufficient decompression of the facial nerve. However, in most cases, recurrent HFS gradually resolved over a period. Based on the compression location, the surgeon could anticipate recurrence of transient HFS.
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Autosomal-dominant polycystic kidney disease (ADPKD) is an inherited systemic condition with a predominant feature of cyst formation in both kidneys. An association with intracranial glioma has not been described previously in ADPKD. ⋯ These 2 independent cases of glioma suggest an unusual clinical manifestation of ADPKD. The potential association between ADPKD and glioma pathogenesis should be further explored.
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The relationship between the use of an endoscope during ventriculoperitoneal shunt (VPS) procedures and infection remains poorly defined. In this study, we sought to analyze whether the simultaneous use of an endoscope could in fact increase the infection rate associated with VPS procedures. ⋯ In the present study, the use of an endoscope during VPS procedures did not increase the risk of surgical infection.
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Spinal arteriovenous malformations (AVMs) are rare lesions that may cause serious neurologic morbidity. With developments in endovascular technology and embolic materials, endovascular management of spinal AVMs has gained popularity. ⋯ Spinal AVMs manifesting as intracranial SAH are uncommon. These lesions are frequently overlooked on cerebral angiography and account for a small proportion of angiogram-negative SAHs. A negative angiogram in the setting of SAH should prompt a comprehensive evaluation of the cervical segmental arterial supply to exclude a cervical spinal AVM. Endovascular embolization may be effective in treating spinal glomus AVMs with good clinical outcomes and with complete angiographic obliteration. Onyx embolic agent should be considered as the agent of choice to manage spinal glomus AVMs.
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To compare surgical outcome both radiologically and clinically after interventions for patients with Moyamoya disease. ⋯ Bypass surgery improved CVRC greater than synangiosis, which may correlate with decreased future stroke risks. The decision for bypass is to be balanced with a greater risk of postoperative neurologic deterioration in adults after this procedure. The hemisphere that did not undergo intervention also appeared to benefit from surgery performed on the contralateral brain.