World Neurosurg
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Aneurysmal bone cysts are benign bone lesions affecting long bones and vertebrae; only 2%-6% have cranial involvement, and even fewer show sphenoid or intraorbital involvement. Gross total resection is the treatment of choice. ⋯ To our knowledge, this is the youngest patient reported to have a spheno-orbital aneurysmal bone cyst. Such lesions in this age group present practical management challenges. By using a modified osteoplastic orbitozygomatic craniotomy, we achieved a gross total resection with minimal brain retraction, avoided the need for plating and suturing at the orbital rim, maintained a vascularized bone flap that is less susceptible to infection, and maintained normal temporalis muscle anatomy with excellent cosmetic results.
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Carotid Doppler sonography has been used routinely in the screening for restenosis after carotid artery stenting (CAS) by applying the criteria of flow velocity; however, computed tomography angiography (CTA) enables us to detect restenosis directly and has some advantages that help to overcome the limitations of Carotid Doppler sonography. We aimed to investigate the incidence of restenosis with CTA and to identify factors related to restenosis after CAS. ⋯ This study revealed that carotid arteries with high-grade calcification were prone to develop restenosis after CAS. Regular follow-up should be performed for the monitoring of restenosis after CAS in patients with highly calcified carotid plaques.
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Perioperative and Postoperative Quality of Life in Patients with Glioma-A Longitudinal Cohort Study.
Few studies have assessed patient-reported quality of life (QoL) in patients with glioma undergoing surgery, and even fewer have provided longitudinal data. Accordingly, there is little knowledge about the changes of QoL over time in patients with glioma. We sought to explore perioperative and postoperative development of generic QoL during the first 6 months after primary glioma surgery. ⋯ At group level, development of generic QoL between baseline and 1 and 6 months postoperatively seems to follow the natural disease trajectories of LGG and HGG, with deterioration in patients with HGG at 6 months. Individual development of QoL is heterogeneous. HGG, resection grades other than gross total resection, and preoperative comorbidity are predictors of postoperative impairment of QoL.
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Hematoma expansion (HE) is closely related to poor outcome in spontaneous intracerebral hemorrhage (sICH). Island sign (IS) is a novel HE predictor based on noncontrast computed tomography (NCCT). This study is aimed to confirm the accuracy of IS for predicting HE and compare it to the spot sign (SS) on computed tomography angiography (CTA). ⋯ IS is independently associated with HE. Although the accuracy of IS for predicting HE is lower than SS, it can be an alternative predictor if CTA cannot be performed.
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It is a common assumption that the human skull and solid skull implants are impermeable to diagnostic ultrasound. We demonstrated in 2 patients that frontoparietal polyetheretherketone cranioplasties allowed useful imaging of intracranial parenchymal and vascular structures with higher ultrasound frequencies than the 2 MHz used for the temporal bone window. This knowledge about additional imaging properties may be helpful in emergency situations and for vascular monitoring. The decision for a polyether ether ketone cranioplasty may contribute to patient safety.