World Neurosurg
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Case Reports
Transclinoid-Transcavernous Approach to A Giant Cavernous Sinus Hemangioma: 2-Dimensional Operative Video.
This surgical video demonstrates a transclinoid-transcavernous approach for the resection of a cavernous sinus hemangioma (Video 1). The patient is a 42-year-old woman who presented with headache and blurred vision. Magnetic resonance imaging (MRI) demonstrated an enhancing mass in the right-side cavernous sinus and sella. ⋯ Final pathology was consistent with a cavernous sinus hemangioma. Postoperative MRI demonstrated near total resection except for a small piece of residual in the sella, which was stable in 6-month follow-up MRI scan without further treatment. The patient has been back to normal life and work.
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There is still a controversy for low-flow extracranial-intracranial or high-flow extracranial-intracranial bypass with proximal occlusion in the treatment of unclippable giant internal carotid artery aneurysms. ⋯ Intraoperative proximal test occlusion is useful to decide on the surgical procedure of revascularization in patients with unclippable internal carotid aneurysm.
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Brainstem cavernous malformations (CMs) are benign lesions, often show an acute onset, and result in a high rate of morbidity. Surgical resection could inhibit the progressive deterioration of neurologic function caused by repetitive hemorrhage. This study aimed to summarize timing, approaches, and techniques of surgery and to evaluate outcomes of treatment. ⋯ Choosing a proper surgical approach and using appropriate techniques are fundamental for favorable outcomes of patients with brainstem CMs.
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To study the safety and performance of real-world thrombectomy using the SOFIA Catheter in our comprehensive stroke center. ⋯ In our single-center experience, thrombectomy using the SOFIA as an intermediate or aspiration catheter provided high recanalization rates under everyday conditions.
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Previous studies have shown that the clivus angle gradient is significantly decreased in patients with Chiari malformation type I (CMI) with an associated syrinx compared with patients with CMI only and a healthy population. To date, the relationship between the clivus gradient and clinical outcomes has remained unclear. The objective of the present study was to investigate whether different clivus gradients (∠α) in CMI after posterior fossa decompression will lead to different clinical outcomes. ⋯ A direct comparison between the 2 groups revealed that a decreased clivus gradient was related to unsatisfactory clinical outcomes. Thus, clivus gradients might emerge as a predictor of clinical outcomes after surgical decompression in patients with CMI.