World Neurosurg
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Wrap-clipping is one of the recommended treatments for ruptured blood blister-like aneurysms (BBAs) of the internal carotid artery (ICA). However, the long-term clinical and angiographic outcomes of this procedure have not yet been elucidated. The present study examined the long-term efficacy of wrap-clipping using a polytetrafluoroethylene membrane, an ideal wrapping material, for BBAs. ⋯ Wrap-clipping using a polytetrafluoroethylene membrane for ruptured BBAs is a useful and acceptable procedure with long-term effectiveness. The effectiveness of this method can be ensured using modern monitoring methods.
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The postoperative infection rates for transforaminal lumbar interbody fusion (TLIF) have ranged from <2% to 4%. However, no consensus has been reached on the treatment strategies. TLIF cage preservation or revision surgery for lumbar spine reconstruction are 2 possible treatments. We aimed to determine the most effective method for organ/space infection control. ⋯ The most important factor contributing to TLIF cage retention failure was epidural fibrosis of the previous transforaminal route and biofilm adhesion on interbody devices affecting infection clearance. Thus, we would recommend a combined anterior and posterior approach or the transforaminal route for radical debridement with cage removal and fusion to achieve better clinical outcomes.
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Case Reports
Reversible severe brainstem herniation and obstructive hydrocephalus from cystoperitoneal shunt overdrainage.
We present a case of symptomatic intracranial hypotension secondary to CSF overdrainage from a cystoperitoneal shunt system. Brain MRI shows distortion of the midbrain with secondary occlusion of the cerebral aqueduct resulting in obstructive hydrocephalus. The symptoms, brainstem herniation, and hydrocephalus resolved after tie occlusion of the shunt.
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Multiple reports have attributed a prognostic value to routine blood tests results for patients with glioblastoma. However, these studies have reported conflicting results and have often had small sample sizes. We sought to validate the prognostic value of the described tests in an independent glioblastoma patient population. ⋯ In the present study, hemoglobin, white blood cell, monocyte, neutrophil, leukocyte, and platelet counts, neutrophil/lymphocyte ratio, C-reactive protein, erythrocyte sedimentation rate, activated partial thromboplastin time, prothrombin time, and lactate dehydrogenase levels did not independently predict for overall survival in patients with glioblastoma.
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To develop a method to distinguish atypical meningiomas (AMs) with malignant progression (MP) from primary AMs without a clinical history. ⋯ Low Cx43 expression and irregular tumor shape were independent predictors of the presence of MP. The relevant logistic regression model was found to be effective in distinguishing MP-AMs from primary AMs.