World Neurosurg
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To review the results of sphenoid sinus lateral recess (SSLR) cerebrospinal fluid (CSF) leaks treated with the endoscopic endonasal minimal transpterygoid approach (EEMTPA) and to discuss the surgical technique and outcomes. ⋯ EEMTPA is a safe and effective method that can be used to treat challenging pathologies at the SSLR, including CSF leaks accompanying meningoencephaloceles. Furthermore, the success rate of EEMTPA for SSLR CSF leaks can be increased by applying endoscopic skull base reconstruction techniques such as the pedicled nasoseptal flap and pedicled middle turbinate flap.
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Chronic subdural hematoma (CSDH) is a highly recurrent disorder. Although some predictors including the use of antithrombotic agents such as aspirin and warfarin have been proposed, the pathogenic mechanism involved remains unclear. Moreover, the link between direct oral anticoagulant (DOAC) agent use and CSDH recurrence has not been reported. The aim of this study was to investigate factors including DOAC use that could potentially be associated with CSDH recurrence. ⋯ The present study found that age and male sex were independently associated with CSDH recurrence, while the use of antithrombotic agents was not.
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Neuroglial cysts (also known as glioependymal cysts) are rare, benign, epithelial-lined cystic lesions that can potentially occur anywhere in the neuraxis. They can be intra, or within, a cranial nerve with the former being more common. The frontal lobe is thought to be the most common location. ⋯ The keyhole supraorbital approach was selected to provide a direct route to the pathology with minimal soft tissue disruption. The patient was discharged on postoperative day 2 without any complications. Follow-up at 6 weeks demonstrated near-complete resolution of her quadrantanopsia and good cosmesis with no frontalis palsy.
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Observational Study
Breaking Bad News to Patients with Intracranial Tumors: The Patients' Perspective.
Bad news refers to information that subjectively impedes a patient's future prospects. Patients with intracranial tumors potentially face numerous pieces of bad news. This study assessed the patients' perspective regarding the content of bad news, patients' preferences for the communication of bad news, and clinical consequences of mismatch of patients' communication preferences. ⋯ Communicating bad news to the patient with a brain tumor in a way that is appreciated by the patient is a complex and demanding endeavor for the treating physician. Meeting patients' needs not only requires the skills regarding the communication of cancer-related news but also accounting for the specific needs ascribable to the neurologic features of the disease (e.g., regarding neuropsychological impairment or neurosurgical treatment).
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To compare transcallosal-transchoroidal and transcallosal-subchoroidal approaches to the ipsilateral and contralateral edges of the floor of the third ventricle using quantitative analyses. ⋯ The transcallosal-transchoroidal approach, compared with the transcallosal-subchoroidal approach, may provide better exposure and require less retraction for removal of ipsilateral or contralateral lesions located in the midbrain or hypothalamus and situated near the floor of the third ventricle. The contralateral transcallosal approach with either the transchoroidal or subchoroidal approach may provide good surgical freedom for removal of lesions located near the floor of the third ventricle, such as lesions in the midbrain.