World Neurosurg
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Aneurysms of the external carotid artery represent approximately 2% of cervical carotid aneurysms, with the majority being traumatic pseudoaneurysms. Given the paucity of literature available for guidance, the diagnosis, treatment, and follow-up of such lesions are completely individualized. ⋯ To the best of our knowledge, this is the second reported case of a true aneurysm of the occipital artery in a patient with no history of trauma. The clinical examination, diagnosis, and treatment are discussed and the literature is reviewed for previously reported cases.
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Presentation of clinical cases involving successful anterior stabilization of the C1-C2 segment in patients with invaginated C2 odontoid process and Chiari malformation type I. ⋯ Anterior decompression followed by anterior stabilization of the C1-C2 segment is a novel and promising approach to treating Chiari malformation type I in association with C2 odontoid process invagination.
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Chronic subdural hematoma (cSDH) is a common neurosurgical ailment, particularly in elderly patients. A recent study uncovered an association between liver disease and recurrence in patients with cSDH. Here, we explored that relationship to identify recurrence predictors in at-risk patients. ⋯ Liver disease is significantly associated with the recurrence of cSDH. Although coagulopathy alone does not predict recurrence, patients with coagulopathy and liver disease are at greater risk for recurrence than those with coagulopathy alone. Liver disease effects are reflected in certain hematologic laboratory values.
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Rapid growth in cerebral cavernous malformation is rare. A review of the literature revealed 4 patients with known cerebral cavernous malformations who later developed a high-grade glioma at the same site. All 4 patients were females, ranging in age from 25 to 71 years, with imaging confirming rapid growth in the lesion. ⋯ We conclude that, although rare, rapid expansion of an existing cavernoma should be considered suspicious for the development of other malignant tumors, and propose adding chronic inflammation in the surrounding brain caused by microbleeds and hemosiderin deposition from the cavernoma to the list of possible causes.
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Case Reports
Ultrasound-assisted neuronavigation-guided removal of a live worm in cerebral sparganosis.
Cerebral sparganosis is a rare zoonotic infestation that often mimics glioma and metastatic tumors. ⋯ Ultrasonography was helpful in the intraoperative localization of the worm and is recommended when intraoperative magnetic resonance is not readily available.