World Neurosurg
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To determine possible systemic factors that may induce or be associated with the pathogenesis and pathologic course of spinal dural arteriovenous fistulas (SDAVFs), the most common type of arteriovenous disorder of the spinal cord and its meninges. ⋯ Our results and data from the literature suggest that arterial hypertension may play an important role in the development of SDAVF-related symptoms or the development of SDAVFs in the presence of other predisposing factors.
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Posterior third ventricular lesions often cause obstructive hydrocephalus. Thus, a combined endoscopic third ventriculostomy (ETV) and endoscopy biopsy are often the first treatment. However, the trajectories for both procedures can differ significantly, necessitating 2 entry points or a combined rigid-flexible technique. ⋯ Although described as a route to reach the anterior third ventricle endoscopically, we describe the use of the transseptal, transcaval, interforniceal approach to reach the posterior part of the third ventricle.
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Primary central nervous system lymphomas (PCNSLs) are relatively rare brain tumors. Accurate diagnosis is usually made by surgical biopsy. In addition to surgical biopsy and decompression, treatment options include high-dose methotrexate and chemotherapy, radiation therapy, and stem cell therapy. Because of the rarity of this disease, guidelines for PCNSL diagnosis and treatment usually are formed from a large series of experiences. ⋯ PCNSL has a poor prognosis. Further clinical trials and diagnostic tools are needed to reveal the complexity of this disease.
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Endoscopic endonasal transsphenoidal surgery (EETS) is increasingly applied to treat tuberculum sellae meningiomas. However, if the tumor adheres firmly to the optic nerve, dissection of the interface between both structures should be prudent to preserve visual function. The purpose of this study was to investigate whether tumor adhesion to the optic nerve can be predicted preoperatively by fast imaging with steady-state acquisition (FIESTA). ⋯ Absence of peritumoral hyperintensity between tuberculum sellae meningioma and the optic nerve on FIESTA may indicate firm adhesion at the interface, severely complicating complete removal. Preoperative recognition of this adhesion is important for safe tumor removal and preservation of visual functions.
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Posterolateral endoscopic trasforaminal discectomy (PELD) requires an ideal percutaneous puncture to place the working channel for endoscopic discectomy. The conventional blinded puncture relies on the surgeon's experience and repeated fluoroscopy, which may increase radiation exposure. This study aimed to introduce isocentric navigation to plan trajectory and guide punctures in PELD. ⋯ Isocentric navigation is feasible in planning the trajectory and guiding the punctures in PELD and could be considered as a potential practical tool to facilitate surgery.