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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To characterize cranioplasty complications and costs at a population level using a longitudinal national claims database. ⋯ A high complication rate is associated with cranioplasty in the United States. Older age, large cranioplasties, and delayed cranioplasties increased complication risk overall. Among patients with emergent indications, complications were associated with delayed time to cranioplasty and autograft usage.
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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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Intraoperative direct stimulation during surgery while awake is considered to be the gold standard for identifying eloquent cortical sites. Only a few studies have referenced the psychologic impact of this event in the pediatric population. ⋯ The results are encouraging, allowing us to contemplate using brain surgery while awake for children without particular worries about the psychologic aspect.
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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.