World Neurosurg
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Skull base chordoma can be a challenging surgical entity because of its invasive nature. ⋯ This study shows that iMRI is a safe method for intraoperative assessment of the degree of resection and the volume and location of residual tumor when resecting skull base chordomas. When gross total resection of the tumor is not feasible, iMRI can be a useful tool for targeted tumor resection.
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We present 3 case reports to share our experience and explore the safety and efficacy of treating huge teardrop fracture of the axis (HTDFA). ⋯ The treatment of HTDFA by Zero-P implant placement combined with miniscrew fixation is effective and stable. The last follow-up examination of the patients showed that fusion had been achieved, and their neck pain had disappeared. Anterior reduction, diskectomy, and Zero-P implantation combined with miniscrew fixation can be used to treat HTDFA. Both avulsed teardrop fragment removal and C2-3 bone grafting lead to bone healing. This method is effective, safe, and simple for the treatment of HTDFA.
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We aimed to evaluate the usefulness of dynamic contrast-enhanced T1-weighted perfusion magnetic resonance imaging (DCE-pMRI) to predict certain immunohistochemical (IHC) biomarkers of glioblastoma (GB) in this pilot study. ⋯ DCE-pMRI could determine surrogate IHC biomarkers in GB via tumoral and peritumoral approach, potential targets for individualized treatment protocols.
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Case Reports
Novel burr hole dilator for endoscopic surgery for intracranial hemorrhagic lesion: technical note.
When performing burr hole endoscopic neurosurgery, it is necessary to get enough surgical corridor. We have used various instruments to extend burr hole size, but it was cumbersome to use so many tools. ⋯ Our dilator for expanding a burr hole improves the work of endoscopic surgery on intracranial hemorrhagic lesions.
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Because of its vascular supply and neurovascular contents, the cavernous sinus (CS) is a challenging area to dissect in the setting of skull base tumors with intracavernous extension or invasion. In the present study, we report the clinical outcomes of 14 patients with tumors with CS invasion that were surgically treated using a direct transcavernous sinus approach for endoscopic endonasal resection of their intracavernous sinus tumors. ⋯ Depending on the space created by intracavernous sinus tumors, use of the transanterior wall for the CS approach in endoscopic endonasal surgery could adequately treat most patients in our case series. This approach provided good visualization of the CS and can be used to treat tumors with favorable outcomes and a low incidence of complications in appropriately evaluated patients.