World Neurosurg
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Non-opacification of frontal and parietal branches after MMA embolization: A radiographic benchmark.
Middle meningeal artery embolization (MMAE) has revolutionized the armamentarium for chronic subdural hematoma (CSDH) treatment. Technical and angiographic benchmarks to guide procedural and clinical success are less well established. ⋯ MMAE with nonopacification of F/P branches was associated with augmented efficacy. Nuanced MMAE adequately tackling culprit dural feeders should be considered for more effective procedures.
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Chronic posthemorrhagic hydrocephalus often arises following spontaneous subarachnoid hemorrhage (SAH). Timely identification of patients predisposed to develop chronic shunt-dependent hydrocephalus may significantly enhance clinical outcomes. ⋯ ML models, including logistic regression, demonstrate strong predictive capability for early chronic shunt-dependent hydrocephalus following spontaneous SAH, which may potentially contribute to more timely shunt placement interventions. This predictive capability is supported by our web interface, which simplifies the application of these models, aiding clinicians in efficiently determining the need for shunt placement.
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Case Reports
An Extremely Rare Case of Collision Tumor: A Craniopharyngioma Coexists Pilocytic Astrocytoma.
A 21-year-old man presented with a 2-day history of cephalalgia and a 1-day history of nausea and vomiting. Neuroradiologic imaging revealed a lesion in the third ventricle accompanied by hydrocephalus. ⋯ Histopathological examination identified it as a rare collision tumor, composed of a mixture of craniopharyngioma and pilocytic astrocytoma. This is an exceedingly rare type of tumor, with no similar cases reported in the existing literature.
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Case Reports
Surgical Video: Percutaneous fusion and endoscopic resection of a thoracic metastatic tumor.
While endoscopic approaches to the spine have become increasingly utilized for spinal degenerative disease, there is a paucity of literature regarding the role of endoscopic approaches in spinal oncology.1 The endoscopic approach offers patients lower risk of wound infection, wound dehiscence, and postoperative hematoma when compared with an open approach.1 In many spinal oncology patients, an endoscopic approach allows for prompt postoperative radiation when compared with an open approach.2 Both the lower complication profile and decreased time to postoperative radiation highlight the importance of considering an endoscopic approach to metastatic spinal tumors. We present a case of a patient with a metastatic carcinoma to the thoracic spine resected via an endoscopic approach. The patient's tumor was first treated with endovascular embolization, followed by endoscopic hemilaminectomy, foraminotomy, and tumor resection. ⋯ Per institutional guidelines, the current case Video 1 did not classify as human subject research or require institutional review board review. In the Video 1, particular focus is placed on the surgical techniques involved in the endoscopic approach for resection a spinal metastatic tumor. With the increasing utilization of endoscopic approaches to the spine, the described technique for resection of spinal metastatic lesions will become increasingly relevant to spinal oncology surgeons.
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Mild craniocerebral trauma (CCT) can lead to various neurological and functional impairments, including dysphagia. Dysphagia refers to difficulties with swallowing, which can significantly impact a person's ability to eat, drink, and maintain proper nutrition. ⋯ Swallowing-feeding management combined with transcranial electrical stimulation is effective in CCT patients with dysphagia.