World Neurosurg
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To assess the quality of life (QoL) in a representative sample of patients with vestibular schwannoma and to ascertain the differences in outcomes associated with distinct management strategies. ⋯ The QoL within this patient cohort was extremely variable in each management group, mirroring the heterogeneous natural history of this disease process. QoL in patients with vestibular schwannoma cannot be predicted based on management strategy alone, but a poor QoL outcome is more likely in patients with larger, symptomatic tumors that are treated surgically.
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In patients with intracerebral hematoma (ICH), it is well known that brain atrophy occurs in the hemisphere ipsilateral to the hematoma. The present study aimed to investigate contralateral hemispheric volume changes in patients with ICH as well as related factors. ⋯ Contralateral parenchymal volumes were significantly decreased at the 3-month follow-up brain computed tomography scan. These findings may offer important clinical information on the remote brain injury of ICH.
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The primary treatment strategy for chronic atlantoaxial rotatory fixation (chro-AARF) is traction followed by bracing or application of a halo device. However, to complete these conservative therapies, patient cooperation is mandatory. If conservative therapy fails, surgery is required for reduction and prevention of recurrence. It has been considered that surgery for atlantoaxial rotatory fixation necessitates solid bony fusion. However, once bony fusion is achieved, loss of range of motion is problematic. Here, we report a patient with chro-AARF who was successfully treated with temporary internal fixation using a C1 lateral mass screw and C2 pedicle screw (Goel-Harms technique) without any grafting of bone or use of bone substitute materials. ⋯ When conservative therapy cannot be continued, Goel-Harms surgery as a temporary internal fixator without bone grafting might be a suitable alternative for selected patients with chro-AARF.
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The magnetic resonance imaging technique known as territorial arterial spin labeling (TASL) allows for noninvasive visualization of perfusion territories. The objective of this study was to use TASL to assess the relationship between perioperative changes in the perfusion territories of the internal carotid artery (ICA) and cerebral blood flow (CBF) after carotid revascularization. ⋯ The TASL study suggested that an imbalance between increases in the PV and ICA flow could play an important role in the pathophysiology underlying postoperative abnormal increases in CBF.