World Neurosurg
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Shape and density of intracerebral hemorrhage (ICH) are associated with a higher risk of poor treatment outcome. However, methods of assessment for the features are still inconclusive. Therefore, we decided to measure ICH shape irregularity using shape factors to achieve objective results. ⋯ Each of the shape descriptors, except FF, was associated with treatment outcome after ICH. FD can be used as an independent predictor of outcome.
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Glioblastoma is the most common primary malignant tumor of the brain. Common radiologic findings using initial computed tomography (CT) reveal an intra-axial lesion with perifocal edema. Here, we present a rare case of diffuse subarachnoid hemorrhage (SAH) detected on an initial CT image in a patient without intracranial aneurysm in whom the final diagnosis was glioblastoma. ⋯ We present a rare case of glioblastoma mimicking SAH of unknown etiology and recommend including glioblastoma in the differential diagnosis of SAH of unknown etiology.
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Three-dimensional images have become an important tool in understanding surgical anatomy. This paper describes a simple method for obtaining endoscopic 3-dimensional anatomic images for teaching purposes. ⋯ Images produced in this way may aid in the understanding of the depth of different structures and ease of learning curve for the use of the endoscopy in neurosurgery.
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The internal maxillary artery (IMA) is a reliable donor for extracranial-intracranial high-flow bypasses. However, previously described landmarks and techniques to harvest the IMA are complex and confusing and require extensive bone drilling, carrying significant neurovascular risk. The objective of our study was to describe a minimally invasive technique for exposing the IMA and to assess the feasibility of using the IMA as a donor for anterior-circulation recipient vessels using 2 different local interposition vessels. ⋯ This study confirmed the technical feasibility of IMA as a donor for an extracranial-intracranial bypass to the second segment of the anterior cerebral artery, M2, and the supraclinoid internal carotid artery. However, IMA-STA-M2 was observed to be the most suitable bypass model.
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Among patients with acute ischemic stroke treated with mechanical thrombectomy (MT), patients with diabetes (DP) show a poorer outcome compared with patients without diabetes (NDP). This study aims to provide a comprehensive analysis of factors associated with unfavorable outcome in DP receiving MT for stroke of the anterior circulation. ⋯ The main factors for an unfavorable outcome of DP after MT are admission hyperglycemia, age, and NIHSS score.