World Neurosurg
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This study aimed to clarify the risk factors of treatment for unruptured cerebral aneurysms (UCAs) in elderly patients by comparing the morbidity at discharge between surgical clipping and endovascular coiling in nonelderly (<65 years) and elderly (≥65 years) patients based on a national database in Japan. ⋯ Endovascular coiling after control of diabetes mellitus was recommended for the treatment of UCA in elderly patients. The ICA location of aneurysm in the elderly should be paid attention as the treatment risk.
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Case Reports
Complete transection of optic nerve after endovascular coiling of a large ophthalmic artery aneurysm: Case report.
We describe a patient who developed delayed blindness of the left eye at 5 weeks after endovascular coiling of a large ophthalmic aneurysm. ⋯ This report describes a rare complication of a sudden increase in size of a large ophthalmic aneurysm despite successful endovascular occlusion.
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Jarcho-Levin syndrome (JLS) is a rare congenital disorder characterized by different clinical and radiologic findings. The disease was first reported by Jarcho and Levin in 1938, and it was described as the presence of various malformations or abnormal fusion in the thoracic vertebrae and ribs, short trunk, and respiratory distress. ⋯ JLS may affect cells derived from the neural crest located between the neural tube and surface ectoderm. Therefore patients with JLS should be screened for other tumors located in this area.
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Case Reports
CDX2 STAINING DEFINES INTRACRANIAL MATURE TERATOMA WITH DIFFERENTIATION TO COLONIC ADENOCARCINOMA.
Malignant transformation of a mature intracranial teratoma into an adenocarcinoma is an extremely rare event and portends a poor prognosis. The clinical progression, radiographic changes, histopathological findings, and immunohistochemistry findings from these unique cases might provide clues regarding this transformation. Caudal homeobox gene-2 (CDX-2) is a specific and robust marker for colonic adenocarcinomas and can also be used to identify differentiation of mature intracranial teratoma into colonic-type adenocarcinoma. To the best of our knowledge, this is the first case report of the use of this specific marker for an intracranial malignancy. ⋯ Malignant transformation of a mature intracranial teratoma portends a poor prognosis. The exact histopathological diagnosis can facilitate treatment of these patients. CDX-2 is a specific robust marker for identifying differentiation of a mature intracranial teratoma into a colonic adenocarcinoma. This positive staining can also be observed in primary colonic and other adenocarcinomas. To the best of our knowledge, this is the first report of the use of CDX-2 in the diagnosis of an intracranial malignancy. The triangulation of clinical progression, radiographic findings, and histopathological and immunohistochemistry findings provided clues regarding this unique transformation.
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Case Reports
Re-perfusion revision surgery for augmented vertebral nonunion with movable cement: A case report.
Osteoporotic vertebral nonunion is a special type of osteoporotic vertebral fracture and can gain satisfactory clinical outcomes using vertebral augmentation. In the rare occurrence that augmented vertebral nonunion occurs postoperatively, pedicle screw fixation is the primary strategy. However, is a different method like the second shot of cement reliable? The purpose of this study is to introduce the reperfusion revision surgery strategy for treatment of osteoporotic vertebral nonunion. ⋯ The patient gained immediate pain relief and vertebral stability after the revision surgery. A 2-year postoperative radiograph and follow-up showed sufficient vertebral height and clinical outcomes. Using special puncture and bone cement perfusion techniques, reperfusion revision surgery in situ is an effective strategy for the treatment of vertebral re-nonunion.