World Neurosurg
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Review Case Reports
Pial arteriovenous fistula with multiple venous aneurysms resembling a vein of Galen aneurysmal malformation.
Pial arteriovenous fistulas are abnormal vascular connections between arteries and the cranial venous system on the surface of the brain in the pia mater. In contrast to vein of Galen aneurysmal malformations, they lack a true vascular nidus and may only indirectly involve the vein of Galen. ⋯ If cerebral venous dilations are encountered, one must keep in mind that the location of the fistula may not be in close proximity to the dilated veins, especially when there is a suspicion for vein of Galen aneurysmal malformation. Other pathologies, such as pial arteriovenous fistula, in a region away from the site of the vein of Galen must be considered.
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Review Case Reports
Morphologic changes after denosumab therapy in patients with giant cell tumor of the spine: Report of four cases and a review of the literature.
To evaluate the quantitative, radiologic, morphologic, and histologic effects of neoadjuvant denosumab treatment (DT) on 4 patients with spinal giant cell tumor of bone (GCTB) and determine the tumor shrinkage effects of DT for spinal GCTB. ⋯ In all patients, osteolytic tumor volume decreased after DT. This tumor shrinkage effect of DT may increase the mechanical stress on the thin cortical rim, leading to the acute collapse of the affected vertebral body if it consists mostly of osteolytic lesions. The presence of adequate anterior cortical bone could prevent acute vertebral collapse after DT.
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Patients with complex, multisutural, and syndromic craniosynostosis (CSO) frequently exhibit intracranial hypertension. The intracranial hypertension cannot be entirely attributed to the craniocephalic disproportion with calvarial restriction because cranial vault expansion has not consistently alleviated elevated intracranial pressure. Evidence has most strongly supported a multifactorial interaction, including venous hypertension along with other pathogenic processes. ⋯ Obstructive sleep apnea, occurring as a consequence of midface hypoplasia, can also contribute to intracranial hypertension in patients with syndromic CSO. Thus, correction of facial deformities, as well as posterior fossa decompression, could also play important roles in the treatment of intracranial hypertension. Determining the precise mechanistic underpinnings underlying intracranial hypertension in any given patient with CSO requires individualized evaluation and management.
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Review Case Reports
Hemangioblastoma of the Cerebral Aqueduct Removed via a Sitting, Supracerebellar Intracollicular Approach.
Tumors protruding into the cerebral aqueduct are rare, and tumors arising from within the cerebral aqueduct are rarer still. ⋯ We report the first case of an aqueductal hemangioblastoma and describe our use of a sitting, supracerebellar, intracollicular approach to access tumors occupying this cerebrospinal fluid space.
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Comparative Study
Comparison of Satellite Sign and Island Sign in Predicting Hematoma Growth and Poor Outcome in Patients with Primary Intracerebral Hemorrhage.
Satellite sign (SS) and island sign (IS) are novel noncontrast computed tomography (CT) predictors of hematoma growth. The aim of this study was to compare diagnostic performance of IS and SS in predicting hematoma growth and functional outcome in patients with intracerebral hemorrhage (ICH). ⋯ IS seems to be an optimal shape irregularity imaging marker for predicting hematoma growth and functional outcome in patients with ICH.