World Neurosurg
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Intracranial de novo arachnoid cysts in adults are rare, suggesting the involvement of head trauma and inflammatory diseases. We report a symptomatic adult case of nontraumatic de novo arachnoid cyst on the ventral medulla oblongata. ⋯ The pathophysiology of nontraumatic de novo arachnoid cysts has many unknown features, and it appears necessary to accumulate further case reports.
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Brain tumors are frequent in clinical practice and associated with high morbidity and mortality. However, many diseases can present as tumefactive lesions and mimic neoplastic lesions. We aimed to determine the frequency of pseudotumoral central nervous system lesions referred to an oncology center and the frequency of the tumor mimickers. ⋯ The frequency of pseudotumoral lesions in an oncology reference center was low. Young women were most affected, and lesions were associated more frequently with systemic autoimmune diseases. Prompt recognition is important to avoid unnecessary treatment, because most patients had a good outcome.
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Case Reports
Surgical rescue technique for incomplete burr hole using a small bone piece and the craniotome.
Incomplete penetration of a burr hole sometimes occurs when performing a craniotomy in elderly patients due to osteoporosis. Completion of the burr hole takes more time and may sometimes cause tearing of the dura mater. We have introduced a small bone piece method that can easily and reliably recover an incomplete burr hole safely. ⋯ Application of the unlocked craniotome on the small bone piece can easily complete the burr hole. Less bone deficit is caused compared with making a new burr hole. In addition, time is saved without changing the attachment, and the burr hole is completed safely. This small bone piece method is effective to recover an incomplete burr hole.
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Medullary infarction (MI) occasionally occurs after treatment of ruptured vertebral artery dissection (VAD). The aim of this study was to validate whether flow reduction for ruptured unilateral VAD by proximal clipping prevents rebleeding and MI in comparison with trapping. ⋯ Appropriate flow reduction for ruptured unilateral VAD by proximal clipping is thought to be effective for preventing rebleeding and avoiding MI.
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In patients with traumatic brain injury (TBI), whether sleep disorder is associated with disturbances in molecular rhythmicity is unclear. This study aimed to investigate the relationship between abnormal sleep and regulation by circadian rhythms in patients with TBI. ⋯ Abnormal expression levels of Per2, Clock, and Bmal1 were detected in patients with TBI-related sleep disorders. These novel findings demonstrate disturbances in the molecular clock in TBI patients and have important implications for our understanding of the aberrant rhythms reported in this disease.