World Neurosurg
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The purpose of this research was to study the outcome of brain metastases in a cohort of patients undergoing a second course of stereotactic image-guided robotic radiosurgery and to identify predictors corelated with survival. ⋯ A second course of CyberKnife radiosurgery seems to be an effective salvage option for brain progression after initial SRS. The total planned target volume shows prediction for OS. Tumor volume of initial SRS may influence selection of the potential population that may benefit from salvage radiosurgery.
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Recent literature has denoted care in an inpatient facility after discharge to be linked with worse outcomes after elective primary lumbar and cervical fusions. No study has explored the risk factors and associated postdischarge outcomes after discharge to inpatient facility after revision posterior lumbar fusion. ⋯ Providers should understand the need of construction of care pathways and reducing discharge to inpatient facilities to mitigate the risks of experiencing adverse outcomes and consequently reduce the financial burden on the health care system.
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Anterior inferior cerebellar artery (AICA) aneurysms are rare with no optimal consensus on management strategies. When treatment requires parent artery occlusion, postoperative ischemic or neuropathic complications can occur. This study evaluated the feasibility of direct revascularization of premeatal AICA using the middle meningeal artery (MMA) as the donor through an anterior petrosectomy window. ⋯ This study establishes the feasibility of MMA-AICA bypass via a middle fossa approach. The matching caliber of the 2 arteries makes end-to-end anastomosis easy to achieve. The MMA is a suitable donor artery that avoids the use of an interposition graft and the complications of extracranial-intracranial bypass.
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Case Reports
Detection of germline mutations of the SMARCB1 gene in a Chinese family with intraspinal schwannomatosis.
Schwannomatosis is the third subtype of neurofibromatosis. Because the tumor is multiple and prone to recurrence, it often brings challenges to clinical diagnosis and treatment. In the past decade, researchers have come to realize the relationship between the SMARCB1 gene and schwannomatosis, which is expected to improve the current level of diagnosis and treatment. ⋯ The structural and functional abnormalities of proteins caused by the mutations of the SMARCB1 gene may be the molecular basis for the pathogenesis of schwannomatosis in this family. This study may provide clues for the study of schwannomatosis in the future.
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Experimental evidence that stent retriever thrombectomy (SRT) may cause arterial wall damage is increasing, although histopathologic findings focused on vessel wall injury after SRT have not fully been reported in humans. ⋯ We provide a histopathologic report of vessel wall injury after SRT that caused failed recanalization. Anatomic variations of the MCA should be considered when selecting suitable thrombectomy devices in order to avoid vessel wall injury.