World Neurosurg
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A 30-year-old man was admitted for sudden loss of consciousness. On angio-CT, a ring-like vascular formation arising from the anterior communicating artery with a low-density center was visualized. This finding was consistent with a giant arterial aneurysm presenting with a central thrombus, also called "donut aneurysm".
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Acute intracranial atherosclerotic disease (IAD)-related large artery occlusion (LAO) is typically refractory to mechanical thrombectomy. We evaluated the feasibility and safety of emergency balloon-assisted or stent-assisted angioplasty performed with tirofiban administration for acute IAD-related LAO. ⋯ Our data point to the safety and feasibility of emergency balloon-assisted or stent-assisted angioplasty performed with tirofiban administration and a single or no passage of the stent retriever for acute IAD-related LAO.
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Review Case Reports
The Unusual Presentation of a Myxoma within the Sphenoid Sinus: Case Report and Review of the Literature.
We describe a rare case of a sphenoid sinus myxoma that was resected via an endoscopic endonasal skull base approach. We review the literature regarding these rare tumors of the paranasal sinuses. ⋯ Myxomas of the sphenoid sinus are rare. The endoscopic endonasal skull base approach is an effective and minimal access technique for resection of this rare tumor of the sphenoid sinus.
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Review Historical Article
Trepanation practices in Asclepieia: systematizing a neurosurgerical innovation.
As ancient Greeks started looking for deities that could fulfill the pragmatic needs of common people, local heroes started being mythologized and worshipped through cults. ⋯ Decompressive craniectomy techniques have been practiced for millennia but it is possible that they were first systematized as a neurosurgical innovation through the Ancient Greek religious cult followed in Asclepieia.
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Atypical meningioma is a World Health Organization grade II tumor with intermediate prognosis and risk of recurrence. Optimal management after gross total resection (GTR) is controversial, with observation versus adjuvant radiotherapy (RT) contentiously debated. ⋯ Observation alone after GTR of atypical meningioma was not associated with increased risk of tumor recurrence or mortality. Although some preceding authors advocate for RT based on empiric experience, a systematic review also suggests that observation may provide equivalent PFS and OS to RT. Taken together, these findings indicate that observation after GTR may be a safe alternative to RT.