World Neurosurg
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To report an outcome analysis following surgical treatment of 45 patients with cavernous hemangiomas involving cavernous sinus. ⋯ Surgery on cavernous hemangiomas of cavernous sinus can be a challenge owing to the vascular profile and complex anatomical location. An extradural approach provides satisfactory exposure for radical tumor resection.
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A large body of evidence has suggested that the natural biology for symptomatic cerebral cavernous malformations (CCMs) is dynamic. These lesions exhibit a temporal clustering epiphenomenon and usually manifest with multispectral clinical patterns, the most relevant being hemorrhagic and seizurogenic events. Most patients with cerebral cavernous malformations are asymptomatic, and the lesions are detected as incidentalomas. ⋯ Early resection of the astrogliotic tissue, barring tissues within the brainstem, following detailed seizure semiology may be beneficial to patients with mesiotemporal lesions and in patients with noncompliance and severe adverse reactions to antiepileptic drug treatment. The proper dichotomization of symptomatic and high-risk cohorts and implementation of stringent surgical strategies performed by experienced surgeons result in good surgical outcomes. The guidelines from the Angioma Alliance Scientific Advisory Board Clinical Experts Panel greatly facilitate in formulating the proper management algorithm.
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Because of their rarity, it is not known whether isocitrate dehydrogenase 2 (IDH2) mutations are related to the occurrence of olfactory neuroblastoma (ONB). We investigated the relationships between IDH2 mutations, clinicopathological parameters, and the prognosis for ONB to establish a molecular classification using IDH2 mutations. ⋯ Immunohistochemistry was a reliable method to assess the mutation status of IDH2. Tumors with IDH2 mutations represented a distinct subset with aggressive behavior and conferred a poor prognosis. The gene status of IDH2 could be a major molecular classification criterion in ONB.
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The risk of wound-related complications, including surgical site infections (SSIs), in patients undergoing surgery for metastatic spine disease (MSD) is high. Consequently, patients requiring wound revision surgery face delay in resuming oncological care and incur additional hospitalization. Recent reports suggest that negative pressure wound therapy (NPWT) applied on a closed wound at the time of surgery significantly reduces postoperative wound complications in degenerative spine disease and trauma setting. Here, we report a single institution experience with incisional NPWT in patients undergoing surgery for MSD. ⋯ Our data suggest that SSI and wound dehiscence are significantly reduced with the addition of incisional NPWT in this vulnerable population.
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The anterior commissure (AC) is one of the main commissural fibers of the brain. The commissural fibers are involved in bilateral integration and coordination of any normal brain activity. The AC is an important interhemispheric structure that forms a bidirectional communication channel between the frontal, temporal, parietal, and occipital lobes bilaterally. ⋯ The use of tractography added extensions to the main AC structure.