World Neurosurg
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Hemangioendotheliomas are rare, intermediate-grade malignant tumors in the neuraxis, mainly involving the brain and meninges. Hemangioendotheliomas of the spine have been encountered more often in the vertebral body than the intradural space. Here, we present a rare case of a unique intradural hemangioendothelioma of the lumbar spine; only a few such cases exist in the literature.
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Cauda equina arteriovenous malformation (AVM) is extremely rare. To our knowledge, only 2 cases have been reported previously and are supplied by a unilateral lateral sacral artery (LSA). Here, we report a rare cauda equina AVM at the level of L5-S1, which is supplied by the bilateral LSAs. ⋯ The present case demonstrated the angioarchitecture of the bilateral arterial supplies and venous drainage of the cauda equina AVMs. Cauda equina AVM with bilateral arterial feeders is extremely rare. However, clinicians should be aware of the possibility of this condition and the importance of selective spinal angiography of bilateral LSAs.
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With the exponential growth of literature on coronavirus disease 2019 (COVID-19), we aimed to identify and characterize the 100 most cited COVID-19-related articles in neurology and neurosurgery. ⋯ This study identified the top 100 most cited neurologic or neurosurgical COVID-19-related articles published to date. This list can be used to identify high-impact studies that will help health care practitioners in clinical decision making and researchers in navigating key areas of study and guiding future research.
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Stereotactic needle brain biopsy is a commonly used neurosurgical procedure. However, up to 15% of biopsies result in undiagnostic pathology reports. Repeat biopsy or continued management without a diagnosis are often considered after undiagnostic biopsies. There have been no reports about the role of postoperative imaging in predicting the diagnostic yield of stereotactic biopsies. ⋯ Fusion of immediate postoperative CT with preoperative imaging is predictive of the diagnostic rate. In cases where the pathology report following a biopsy is not diagnostic, this fusion may be useful in making decisions regarding repeat biopsy or considering other diagnostic options.
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Vertebral artery-posterior inferior cerebellar artery (VA-PICA) aneurysm is challenging owing to its variable anatomy and interference of lower cranial nerves. A recurrent ruptured VA-PICA aneurysm was successfully treated by occipital (OA)-PICA bypass with aneurysm trapping (Video 1). Informed consent was obtained from the patient. ⋯ Occlusion of the aneurysm was achieved by placing permanent clips on the VA proximal and distal to the aneurysm and the PICA next to the aneurysm sac without occluding the perforator. The postoperative course was uneventful with bypass patency. We believe this case demonstrates the surgical tenet of OA-PICA bypass for VA-PICA aneurysm.