World Neurosurg
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A few cases of spontaneous regression of germ cell tumors have been reported. Possible mechanisms include steroid medication, surgical intervention, diagnostic radiation exposure, and immune response. None of these hypotheses has been supported by sufficient data. ⋯ This unusual phenomenon of spontaneous regression of germinoma may be caused by a combination of pathognomonic characteristics of anatomic location with paraventricular development and stress induction as a trigger, such as salvage surgery or diagnostic radiation, including at extremely low dosage.
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To evaluate the feasibility and clinical value of magnetic resonance diffusion tensor imaging (DTI) with fluorescein sodium staining (FLS) in the resection of high-grade glioma (HGG) in functional brain areas. ⋯ The application of DTI with FLS can facilitate the maximum resection of HGG in functional brain areas with minimum loss of fiber tracts, reduce the disability rate, and improve quality of postoperative life compared with traditional glioma surgery.
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Ligaments of the craniocervical junction play a critical role in stabilizing this region. Gerber's ligament has more or less been forgotten and, to our knowledge, never studied. ⋯ A good understanding of all ligaments of the craniocervical junction is important to surgeons and physicians treating patients with injury to the upper cervical spine.
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In complex lumbosacral lipomatous malformation or retethering, "crotch" dissection, an incision on the dura or lipoma at the site lateral to the lipoma-cord fusion line saving underlying roots, is often not easy. Attempts of this dissection in complex and obscured conditions may cause damage to the spinal cord or nerve roots. A method for caudal extension of untethering while positive areas on electrical stimulation were encountered during the crotch dissection of lumbosacral lipomatous malformation is described. ⋯ By using this method, safe untethering can be achieved avoiding root injuries in complicated lipomas such as chaotic or retethering cases.