World Neurosurg
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Postoperative hemorrhage (POH), an uncommon complication after cranial operation, may result in prolonged postoperative hospitalization, severe neurologic impairment, or even death. Most models in studies detecting risk factors for POH include all kinds of cranial lesions; however, factors associated with POH may vary among intracranial diseases. There is a paucity of large sample studies focusing solely on POH after intracranial tumor surgery. Therefore, this study was designed to investigate the preoperative risk factors for POH after surgery for intracranial tumor. ⋯ Older age, higher INR, and larger tumor size were identified as independent risk factors for POH after resection of intracranial tumor in adults.
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Extraventricular neurocytoma (EVN) is an exceedingly rare brain tumor. The radiologic and histologic features of EVN are insidious, and only a few reports and clinical cases describe the characteristics of the tumor, which may show different presentations. ⋯ In light of the high variability of imaging presentation, the definitive diagnosis of EVN remains histologic. Although some cases have already been reported in the literature, we believe that the description of our case could be useful to increase the knowledge of this insidious tumor, which has gained recognition only over the past 2 decades and should be included in the differential diagnosis in young patients who present brain tumors.
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Vertebral artery injuries (VAIs) caused by cervical trauma include irregularities with narrowing of the arterial wall, dissection, pseudoaneurysm formation, occlusion, and transection. Although recent guidelines have recommended anticoagulant or antiplatelet therapy to prevent subsequent stroke in patients with traumatic VAIs, regardless of the type of vascular injury, the clinical role of endovascular surgery in the treatment of traumatic VAIs remains to be elucidated. ⋯ The clinical role of endovascular surgery for traumatic VAI has not been previously established; however, a more specific selection of patients according to the VAI type might be necessary. Our data have indicated that preoperative embolization of the occluded VA significantly reduces the risk of postoperative infarction in a specific cohort of patients with traumatic VAI (i.e., patients with post-traumatic VAO who require cervical surgery).
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To describe a minimally invasive decompression technique for symptomatic spinal epidural lipomatosis using percutaneous biportal endoscopic surgery. ⋯ Percutaneous spinal endoscopy is a minimally invasive muscle-preserving technique for spinal lipomatosis that achieves neural decompression directly by lipoma removal and indirectly by partial bone and ligament removal.
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Intramedullary spinal cord cavernous malformations (ISCCMs) are a rare entity. Most commonly, ISCCMs present with neurologic decline from lesion hemorrhage, which can be catastrophic and irreversible irrespective of surgical intervention. Given the challenging anatomic location of these lesions in highly critical neurologic areas, precise surgical localization and visualization is necessary to limit collateral damage during resection particularly for deep ISCCMs that do not present to a pial surface. ⋯ The approach represents a novel application of intraoperative CT navigation assistance in the resection of deep ISCCMs.