World Neurosurg
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Microvascular decompression of the trigeminal nerve is the most effective treatment for trigeminal neuralgia. However, when encountering classical trigeminal neuralgia caused by venous compression, the procedure becomes much more difficult, and failure or recurrence because of incomplete decompression may become frequent. This study aimed to investigate the anatomic variation of the culprit veins and discuss the surgical strategy for different types. ⋯ The accuracy recognition of anatomic variation of the SPVC is crucial for the management of classical trigeminal neuralgia caused by venous compression. Selecting an appropriate approach and using reasonable decompression methods can bring complete postoperative pain relief for most cases. NC can be an alternative choice for extremely difficult cases, but it could lead to facial numbness more frequently.
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To investigate characteristics of the posterior cerebral artery anterior temporal branch aneurysm and the safety and efficacy of endovascular management. ⋯ The anterior temporal artery aneurysm is a special subtype of aneurysm and can be readily misdiagnosed as on the posterior cerebral artery trunk or the superior cerebellar artery. Endovascular management has a greater success rate, good effect, and fewer complications but with greater difficulties.
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Case Reports
Coil and Single Stent Placement for Ruptured Dissecting Aneurysm of Middle Cerebral Artery: a case report.
Ruptured dissecting aneurysms located at the middle cerebral artery (MCA) are rare, and their standard treatment has not been defined. Furthermore, lenticulostriate artery involvement in the dissecting segment makes treatment extremely difficult, and no previous reports have described successful treatment for such conditions. ⋯ Follow-up digital subtraction angiography performed 5 weeks after endovascular therapy showed healing of the dissecting lesion, and the patient was discharged neurologically intact.
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Matrix metalloproteinase-9 (MMP-9), pituitary tumor transforming gene (PTTG), and high mobility group A 2 (HMGA2) play important roles in the tumorigenesis of adrenocorticotrophic hormone (ACTH)-secreting pituitary tumors, but their associations with tumor recurrence after transsphenoidal adenomectomy remain unclear. The aim of the study was to investigate the immunohistochemical expression profiles of MMP-9, PTTG, HMGA2, and Ki-67 in recurrent and nonrecurrent ACTH-secreting pituitary tumors and to identify their associations with tumor behavior and recurrence status. ⋯ ACTH-secreting pituitary tumors with greater levels of MMP-9 were associated with a greater recurrence rate and a shorter recurrence-free interval. MMP-9 could be a valuable tool for predicting recurrence of ACTH-secreting pituitary tumors.
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Case Reports
Exophytic cerebral hemispheric low grade glioma: An unusual growth pattern of a common central nervous system tumour.
Exophytic growth (EG), wherein the tumor mass grows beyond the neuraxial boundary formed by pia mater, remains a rare pattern of glioma growth. It has been described in gliomas at several locations like the brainstem, cerebellum, suprasellar area, spinal cord, and insula. However, EG in hemispheric grade 2 astrocytomas, particularly affecting the convexity subarachnoid space, as against the more spacious basal subarachnoid space, is exceedingly rare. To the best of our knowledge, there is only 1 such case reported in the English literature. Due to the extreme rarity, little is known about these tumors, particularly the mechanisms underlying the EG and their possible clinical implications. ⋯ Although extremely rare, cerebral hemispheric grade 2 astrocytomas may have an EG pattern. The exact mechanisms underlying this are not clearly known. More such cases need to be reported so that we can decipher the true nature of these tumors.