World Neurosurg
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Congenital microcephaly could result from a gene mutation. Asparagine synthetase deficiency, which is caused by the asparagine synthetase (ASNS) mutation, is a rare autosomal-recessive neurometabolic disorder. It is characterized by severe developmental delay, congenital microcephaly, and seizures. ⋯ Although there is no cure for this disorder so far, the huge progressive intracerebral cyst can be cured by a cyst-peritoneal shunt.
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Case Reports
A cerebral aneurysm arising from a variant posterior communicating artery lying lateral to the oculomotor nerve.
In most cases, the posterior communicating artery (PCoA) lies medial to the oculomotor nerve. In this report, a rare case of a ruptured cerebral aneurysm arising from a variant PCoA lying lateral to the oculomotor nerve is described. ⋯ Recognizing this anatomic variant is helpful in minimizing the potential complications in microsurgical management around the PCoA and oculomotor nerve. Lateral localization of the P1-2 junction might affect this rare anatomic variant.
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The association between a dural arteriovenous fistula (dAVF) and perimedullary arteriovenous fistula (AVF) is rarely observed at the craniocervical junction (CCJ). We present a case of subarachnoid hemorrhage (SAH) with concurrent dAVF and perimedullary AVF at the CCJ. Here, we describe the cause of bleeding and the process of determining whether it was a varix or an arterial aneurysm. ⋯ In recent reports, SAH caused by concurrent dAVF and perimedullary AVF raised the possibility of an arterial aneurysm. However, in this case, the possibility of venous bleeding was high and a varix rather than an aneurysm was observed. On the basis of the reported cases, concurrent dAVF and perimedullary AVF at the CCJ is a "middle-flow arteriovenous shunt" that may induce a varix or an arterial aneurysm.
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This 3-dimensional histologic study aimed to provide a precise description of the meningeal structures in the jugular foramen. ⋯ Knowledge of the anatomy of the meningeal architecture of the jugular foramen can be helpful in avoiding surgical complications of the lower cranial nerves when this complex area is approached.
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To investigate the risk factors in the development of pneumonia and its impact on outcome after primary intraventricular hemorrhage (PIVH). ⋯ GCS score and stroke history were independent predictors of pneumonia development after PIVH. Pneumonia after PIVH was associated with longer duration of hospital stay and poorer outcome at 90 days.