World Neurosurg
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Previous studies have suggested that the cystic change of pituitary adenoma might be related to the blood supply and metabolism of the tumor; however, the exact pathologic mechanism underlying the cystic change remains unknown. ⋯ Regional blood supply is unevenly distributed in the parenchymal pituitary adenoma, with reduced blood supply in the upper than the lower region. Cystic change mainly occurs in the upper region of pituitary adenoma.
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Rheumatoid arthritis (RA) is an autoimmune disease that often occurs in the atlantoaxial segment of the cervical spine and results in instability that can cause severe pain and neurologic symptoms. Thickening of soft tissue posterior to the odontoid process of the atlantoaxial segment is referred to as retro-odontoid soft tissue (ROST) thickness or pseudotumor. The mechanism of ROST thickness is still unknown. ⋯ This study showed a statistical correlation between ROST thickness and ADI related to biomechanical changes in the dynamic atlantoaxial segment, thereby suggesting the value of a prospective study.
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Motor nerve biopsy is performed to supplement clinical, serologic, and imaging data in the workup of neuropathies of unknown origin, especially when motor neuron disease is suspected. ⋯ Biopsy of the motor branch of the superficial peroneal nerve to the peroneus longus is a safe and effective alternative for motor nerve biopsy and can be easily combined with peroneus longus muscle biopsy.
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Frontoethmoidal encephalocele is a congenital abnormality of the anterior skull base involving herniation of cranial contents through a midline skull defect. Patency of the foramen cecum, along with other multifactorial variables, contributes to the development of frontoethmoidal encephaloceles. Because of limited resources, financial constraints, and lack of surgical expertise, repair of frontoethmoidal encephaloceles is limited in developing countries. ⋯ Despite the limitations of performing advanced surgery in a developing country, the combined interdisciplinary surgical approach has offered effective treatment to improve physical appearance and psychological well-being in afflicted patients.
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Dural arteriovenous fistula (DAVF) with cortical venous drainage is known to be aggressive in clinical course and is usually managed promptly. Spontaneous resolution of DAVF is a rare phenomenon and usually occurs in benign fistulas. Spontaneous thrombosis of aggressive DAVF is an extremely rare occurrence. The present study aimed to identify the incidence and factors determining spontaneous resolution of aggressive DAVF. ⋯ Spontaneous thrombosis of aggressive DAVF is a known phenomenon in the natural evolution of cerebral dural arteriovenous malformation. DAVF architecture could categorize this particular subset of DAVF, which had an overall good prognosis. Further observations in large multi-institutional cohorts are needed to validate this finding and to ascertain other factors precipitating this outcome.