World Neurosurg
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Restricted access to hospitals due to the 2019 novel coronavirus disease (COVID-19) pandemic has significantly altered practice patterns for elective neurosurgical care. Particularly, telemedicine has become the primary modality of patient visits for nonemergent conditions. This study aimed to characterize user experiences of neurosurgeons and advanced practice providers focusing on perceived utility and barriers of telemedicine in management of elective neurosurgical patients during COVID-19. ⋯ During the COVID-19 period, telemedicine was heavily relied on to ensure the continuation of perioperative care for patients with elective neurosurgical pathologies. While clinicians identified numerous barriers for current telemedicine platforms, the use of telemedicine will likely continue, as it has provided unique benefits for patients, clinicians, and hospitals.
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Case Reports
Neurocysticercosis Superimposing Schwannoma: A Unique Combination of 2 Pathologies at Cerebellopontine Cistern.
Neurocysticercosis, a common parasitic infection in developing areas, usually exists in supratentorial parenchyma. Literature review shows few case reports published for cerebellopontine angle cysticercosis, but its coexistence with a schwannoma in the same cistern has never been seen before. This leads to confusion in preoperative diagnosis and management. ⋯ Cysticercosis should be kept as a differential diagnosis in cystic lesions of the CP angle, especially in endemic areas and even in cases showing obvious cystic schwannoma on imaging. Care should be taken to prevent spillage of cyst contents while puncturing the cyst wall for a better outcome.
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Flow diverters are novel, contemporary tools in treating intracranial aneurysms. There is rapid publication turnover, with newer devices introduced and expanding indications. The bibliometric analysis measures the impact of particular articles and summarizes the chronologic trends overall. ⋯ This bibliometric analysis shows significant chronologic trends, with a shift from usefulness and outcome to short-term and long-term complications. Areas to improve in flow diverter research can be addressed after this analysis of the most impactful articles on this topic.
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Comprehending the risk factors that contribute to the formation of fusiform aneurysms (FAs) might provide some insight into treatment and prevention strategies. This case-control study aimed to compare the levels of serum C-reactive protein (CRP), as a biomarker, between patients with fusiform and saccular intracranial aneurysms. ⋯ CRP was higher in patients with FAs than controls, and it constituted an independent predictor of fusiform morphology for patients with unruptured aneurysms. Inflammation might be an especially important factor in FA formation and growth, and further studies could use this finding to design new treatment strategies.
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The treatment of patients with ≥11 brain metastases (BMs) with stereotactic radiosurgery (SRS) alone has yet to be established. The aim of this study was to compare results of SRS alone in patients with 5-10 BMs versus 11-20 BMs. ⋯ Carefully selected patients with 11-20 BMs are not unfavorable candidates for SRS alone.