World Neurosurg
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Arachnoid webs are rare intradural lesions that can cause direct spinal cord compression or alteration of the cerebrospinal fluid flow with syringomyelia. Surgery has been historically performed through wide-open laminectomies. The aim of this study is to prove the feasibility of minimally invasive techniques for the excision of arachnoid webs. ⋯ For symptomatic arachnoid webs, surgery remains the only definitive treatment. In expert hands, the excision of arachnoid webs can be achieved with tubular retractors and minimally invasive techniques.
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Spinal extradural arachnoid cysts are relatively uncommon. Rarely, large cysts presented with spinal cord compression requiring surgical intervention. ⋯ This case illustrates the principles of timely surgical intervention after advanced diagnostic imaging and electrodiagnostic testing to improve neurologic function and minimize complications.
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Perforating arteries are thin and long vessels which originate from the main cerebral arteries. Subarachnoidal hemorrhage from a perforator aneurysm is rare. ⋯ MR imaging, however, demonstrated occlusion of the aneurysm secondary to thrombosis. Surgery was performed to remove the associated hematoma, and histopathological examination verified intraaneurysmal thrombosis.
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The incidence of meningioma has increased drastically recently, particularly in older adults. Surgical intervention has the potential to reduce neurologic symptoms and achieve favorable, long-term outcomes. There is considerable variability in the literature examining the relationship between age and outcomes after meningioma surgery. The objective of this study was to identify the relationship between age and postoperative complications after craniotomy for resection of meningioma. ⋯ Advanced age, particularly >80 years, is an independent predictor of morbidity and mortality in patients undergoing craniotomy for resection of meningioma. As such, it should be considered in preoperative optimization and risk stratification.
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Numerous scores have been developed for prognostication of outcomes in intracerebral hemorrhage (ICH). Prediction models must be validated internally and externally before they are considered widely applicable. We aim to independently externally validate and compare 3 prediction models (ICH score, ICH grading scale [ICH-GS], and simplified ICH [sICH]) in our population, which has not been previously done. ⋯ This study successfully independently validates the ICH score, ICH-GS, and sICH score in a large patient cohort with spontaneous ICH, which has not been previously done in this non-Western population. We recommend the use of the ICH-GS as a prognostication tool in our patients instead of the widely used ICH score.