World Neurosurg
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Central neurocytomas are benign tumors accounting for <0.5% of all intracranial tumors. They are usually intraventricular, the most common site being the lateral ventricles, and are associated with good prognosis if they are completely resected surgically. ⋯ Gross total resection should be the goal in all patients with central neurocytoma, but it may be limited because of proximity of the tumor to eloquent areas, especially in large tumors. Intraoperative neuromonitoring plays a pivotal role in maximal safe resection of such large tumors. Tetraventricular atypical central neurocytoma is a very rare entity; and this case could be, to the best of our knowledge, only the second reported case.
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A small number of reports have described subarachnoid hemorrhage resulting from a ruptured aneurysm embedded within a prolactinoma. To the best of our knowledge, no reports have described an embedded carotid cavernous fistula. We report a patient with carotid cavernous fistula secondary to a ruptured internal carotid artery aneurysm embedded within a prolactinoma. ⋯ An aneurysm embedded within a prolactinoma should be closely observed when cabergoline administration is started.
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Recent three-dimensional constructive interference in steady state (3D-CISS) studies have shown that the involved arteries decrease not only their own luminal caliber but also outer diameter in moyamoya disease (MMD). This study was aimed to clarify how the outer diameter of the involved arteries serially change during disease progression in MMD using qunatitaive 3D-CISS imaging. ⋯ Using quantitative 3D-CISS imaging, this study clearly shows that the involved arteries serially decrease in their own outer diameter in parallel with luminal stenosis during spontaneous disease progression in early stages of MMD (stage 1-3). This phenomenon has not been reported previously and may result from the pathognomic mechanisms underlying the development of MMD.
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Central nervous system dermoid cysts are rare lesions derived from ectopic epithelial cells. They are slow-growing benign tumors but may cause significant morbidity through compression of neurologic and vascular structures and, rarely, rupture into the subarachnoid space. ⋯ The dermoid cyst is a rare entity, the rupture of which is exceptional and often spontaneous. It is manifested by a polymorphic and nonspecific clinical picture requiring the use of imaging. This is based on CT and especially MRI, which make it possible to positively diagnose the nature of the cyst and the rupture, specify the extent of the dissemination of the lipid content in the subarachnoid spaces, and detect possible complications such as hydrocephalus. It also makes it possible to carry out a precise topographic assessment to plan the therapeutic conduct and guide a possible surgical intervention.
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To determine the effectiveness of basal membranotomy performed to ensure cerebral expansion in patients operated for chronic subdural hematoma. ⋯ The mini craniotomy-basal membranotomy technique provided statistically significantly better cerebral expansion in patients with chronic subdural hematoma when compared with the double burr hole drainage technique.