World Neurosurg
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The safety of carotid artery stenting (CAS) in elderly patients is controversial. The aims of this study were to evaluate 30-day outcomes after CAS in elderly patients (≥70 years old) and to investigate risk factors for postoperative incidence of major adverse clinical events (MACE) to improve CAS safety based on clinical evidence in this specific subgroup of patients. ⋯ At our center, CAS was safely performed in elderly patients. A family history of stroke, symptomatic status, and modified Rankin Scale score ≥3 indicating a neurologic deficit increased the risk of 30-day postoperative MACE.
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In this article, we describe a new safe entry point for the posterolateral pons. ⋯ The interpeduncular sulcus safe entry zone provides an alternative direct route for treating intrinsic pathologic entities situated in the posterolateral tegmen of the pons between the superior and middle cerebellar peduncles. The surgical corridor provided by this entry point avoids most eloquent neural structures, thereby preventing surgical complications.
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Despite recent improvements in treatment of glioblastoma (GBM), some patients still have a short survival. We sought to develop a new risk score for preoperative assessment of short-term survival (STS) (<6 months) in patients with GBM. ⋯ This study presents the SHORT score for preoperative assessment of STS risk in patients with GBM. This risk score needs external validation in larger patient cohorts from other institutions. Our score might be a tool to facilitate treatment decisions in patients with GBM before surgery.
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Melanocytic lesions of the nervous system are thought to arise from leptomeningeal melanocytes, which are derived from neural crest and include diffuse melanocytosis, melanocytomas, and malignant melanomas. Meningeal melanocytomas are extremely rare benign lesions. The usual treatment of intradural extramedullary melanocytomas involves surgical removal through a posterior approach using a laminectomy or laminotomy. ⋯ There is no evidence of recurrence at 4-year follow-up records of the patient. We discuss the surgical approach of these rare lesions.
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This paper explores the diagnosis of deep invasive endometriosis through retrospective data analysis, including deep infiltration and magnetic resonance imaging. The literature retrospectively collected data from 21 patients with deep invasive endometriosis who were admitted from 2012 to 2018. The patients were confirmed to have pain and nerve growth factor (NGF) receptor expression levels after operation and underwent vaginal color ultrasound and magnetic resonance imaging before surgery. ⋯ Through research it has been found that deep invasive endometriosis mainly involves the uterine fibula ligament, vagina, uterus rectum, rectum, ureter, and so forth. Patient pain is related to the expression level of NGF receptor, and its magnetic resonance mainly manifests as signals and structural obstacles, irregular thickening of the affected area, or nodular formation and deformation of adjacent tissues and organs. Through research and demonstration of deep invasive endometriosis, transvaginal color ultrasound and magnetic resonance imaging can not only accurately locate the expression levels of pain and NGF receptors, but also show the extent of the lesions, thereby studying pain and NGF receptor expression, which is an important method for preoperative examination and postoperative follow-up.