World Neurosurg
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Identification of Key Risk Factors for Rupture in Small Intracranial Aneurysms: A Multicenter Study.
Predicting rupture risk in small intracranial aneurysms (IAs) < 5 mm is crucial for guiding clinical decisions. This study aims to identify key clinical and morphological risk factors associated with rupture in small IAs, providing better insight for decision-making. ⋯ This study identifies and validates critical risk factors associated with small IA rupture and presents a clinically useful, high-accuracy predictive model to aid in individualized patient management.
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To evaluate the efficacy and prognosis of intraventricular medication (IVM) administered via the reservoir of Ommaya or ventricular shunt (VS) system to control leptomeningeal metastases, with or without VS based on intracranial pressure, in combination with postoperative systemic therapy. ⋯ For leptomeningeal metastases, VS not only significantly alleviates symptoms caused by intracranial hypertension but also avoids sudden death for those with severe intracranial hypertension. However, VS placement only does not improve overall survival. IVMs controls effectively leptomeningeal metastases, significantly prolongs survival, enhances quality of life.
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Severe vessel tortuosity may prevent a microcatheter from reaching a distal vessel. However, the double-wire technique (DWT) may facilitate the procedure. The present study evaluated the feasibility and safety of guiding a 0.027-inch microcatheter into a distal vessel beyond the tortuous internal carotid siphon (ICS) using the DWT. ⋯ Although a 0.027-inch microcatheter is difficult to guide beyond a tortuous ICS to a distal internal carotid artery using only a single wire, the application of the DWT may allow the catheter to be guided without increased complications.
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The aim of this study was to synthesize existing knowledge regarding the anatomy of the cavernous sinus (CS), critically evaluate the current anatomical hypotheses concerning its walls, to conduct anatomical dissections, and develop a comprehensive understanding of the connective tissue structure of the CS. ⋯ The dural anatomy of the CS involves an intricate interplay between the meningeal and periosteal dural layers, which is elucidated more effectively through the application of fundamental principles informed by embryological development.
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Multinodular and vacuolating neuronal tumors (MVNTs) of the cerebrum are rare, seizure-related, low-grade tumors of the central nervous system that usually affect young adults. First described by Huse et al. in 2013, these neoplasms are usually located within the deep cortical ribbon and the superficial white matter and have a characteristic cytoarchitecture of cells with neuronal and glial differentiation that form multiple nodules with conspicuous vacuolation. Because of their benign nature and indolent clinical course, radiologically based differentiation from other entities is of paramount importance to avoid unnecessary surgical intervention. ⋯ Their most frequent initial clinical manifestation was either seizures or headaches. On conventional magnetic resonance imaging techniques, they usually appear hypointense in T1-weighted images and hyperintense in T2-weighted and fluid-attenuated inversion recovery images and lack perilesional edema or postcontrast enhancement. MVNTs do not seem to change size or recur, even after partial resection of the tumor, indicating their indolent course, and, thus, surveillance with serial magnetic resonance imaging is the most appropriate management technique for these lesions.