World Neurosurg
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Review Case Reports
Embolization of Ruptured Distal Lenticulostriate Artery Aneurysms.
To describe the critical role of endovascular treatment and safety for the patients who presented with intraventricular hemorrhage owing to rupture of the distal lenticulostriate artery aneurysms. ⋯ Endovascular therapy is available and safe as a treatment option for distal lateral lenticulostriate artery aneurysms.
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The nondominant hemisphere (usually right) is determinant for main cognitive functions such as visuospatial and social cognitions. Awake surgery using direct electrical stimulation for right cerebral tumor removal remains challenging due to the complexity of the functional anatomy and the difficulties in adapting the classical bedside tasks for awake surgery conditions. ⋯ In this second review of 2 parts, we discuss the pertinence of the neuropsychological tests available for the study of nondominant hemisphere functions for the surgery on right-sided tumors in awake surgery conditions. In conjunction with part I of the review, which focuses primarily on the anatomical, functional, and semiological basis of the right hemisphere function, this article provides a comprehensive review of current knowledge supporting the awake surgery in the right hemisphere.
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Review Case Reports
Treatment of Partially Thrombosed Intracranial Aneurysms: Single-Center Series and Systematic Review.
Partially thrombosed intracranial aneurysms (PTIAs) represent a challenging subgroup of aneurysms, with an organized intraluminal thrombus and a solid mass, in which the optimal therapeutic strategy is discussed controversially because of limited data. We therefore analyzed the results of surgical and endovascular treatment in patients with PTIAs treated in our department and combined the results with a systematic literature review. ⋯ In this study, surgical treatment of PTIAs showed superior initial radiologic results and better long-term stability than endovascular treatment. Therefore, surgical treatment should be considered in those patients harboring PTIAs who are qualified as suitable surgical candidates after interdisciplinary consensus.
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The giant calcified herniated thoracic disc (HTD), a rare disease, is a challenge for surgeons because of its complications. This review aimed to confirm the surgical treatment, including surgical approach, results, and complications of HTDs. ⋯ Surgical treatment can improve or stabilize neurologic impairment for most patients with giant calcified HTDs. We thus recommend the anterior thoracotomy approach for giant calcified HTDs because of the theoretical advantages over other approaches and the low rate of neurologic deterioration, subarachnoid-pleural cerebrospinal fluid fistula, and reoperation.
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Craniopharyngiomas (CPs) and their treatment are associated with hypothalamic damage that causes hypothalamic obesity (HO) in 30%-70% of cases. Thus, there is ongoing research regarding tangible solutions for HO, because these patients have unrelenting resistance to basic weight-loss interventions. This review aims to summarize the interventions that are used to treat CP-related HO (CP-HO), including pharmacotherapy and bariatric surgery. ⋯ Octreotide appears to be a preferred treatment for patients with CP-HO, based on limited data. Gastric bypass surgery may also be suitable for select patients with CP-HO, based on a review of various procedures in this setting. Microsurgical preservation of the hypothalamic structures is mandatory to decrease CP-HO-related morbidity and mortality. Further studies with adequate analytical power and sufficient follow-up are needed to identify effective strategies for CP-HO treatment.