World Neurosurg
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Cerebral venous sinus thrombosis (CVST) is a relatively uncommon cause of stroke in pediatric patients and young adults. The clinical course of CVST is also highly variable. In particular, coma has been noted as a predictor of poor outcome. The standard treatment for CVST in adults is systemic anticoagulation, which can lead to recanalization. Endovascular mechanical thrombectomy (EMT) is considered as possibly indicated in the event of failure to respond to anticoagulation or a comatose state. However, the role of endovascular therapy in the management of pediatric and young adult CVST is unclear. Here, we describe 3 cases of successful emergent EMT for pediatric and young adult CVST presenting in a comatose state. ⋯ Pediatric and young comatose CVST warrants endovascular mechanical thrombectomy as soon as possible.
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Comparative Study
The Differences Between Intracranial Mesenchymal Chondrosarcoma and Conventional Chondrosarcoma in Clinical Features and Outcomes.
To report differences in clinical features and outcomes between intracranial mesenchymal chondrosarcoma (MCS) and conventional chondrosarcoma (CCS). ⋯ Clinical features of MCS are quite different from CCS. Treatment strategies used for CCS do not yield satisfactory outcomes for MCS. Treatment of MCS should be aggressive and individualized.
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Anterior communicating artery (ACoA) complex aneurysms are challenging to treat microsurgically. The authors report their experience with microsurgical treatment of ACoA aneurysms and examine the anatomic characteristics of these aneurysms as predictors of outcome. ⋯ The aneurysm's exact location in relation to the adjacent neurovascular structures is potentially predictive of outcomes in the microsurgical treatment of ACoA aneurysms.
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Case Reports Comparative Study
Quantitative endoscopic comparison of contralateral interhemispheric transprecuneus and transtentorial transcollateral sulcus approaches to the atrium.
The contralateral interhemispheric transprecuneus approach (CITP) and the supracerebellar transtentorial transcollateral sulcus approach (STTC) are 2 novel approaches to access the atrium of the lateral ventricle. We quantitatively compared the 2 approaches. ⋯ Both approaches were feasible for accessing the atrium. The STTC provided a shorter working distance and wider mediolateral angle, CITP provided a wider rostrocaudal angle of attack and better exposure and maneuverability to the anterior and superior atrium. In contrast, the STTC was more favorable for the inferior and posterior regions.
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Exposure to neurosurgery at the undergraduate level is an important factor in determining future interest in and applications to the specialty. Given the high competition for training posts, this exposure is also becoming an almost essential addition to an applicant's portfolio. We organized a neurosurgical conference aimed at undergraduate medical students. The aim of this study was to determine factors attracting and deterring students from the specialty before and after the conference. ⋯ The most notable factor deterring students from a career in neurosurgery was work-life balance. Other deterring factors were much less prevalent following the conference. Understanding how exposure to neurosurgery influences students' perceptions is important for developing future initiatives to prevent misconceptions and allow students to make informed choices as well as encourage the right candidates to apply.