World Neurosurg
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Optic pathway gliomas (OPGs) are relatively rare, and their presentation after the first decade of life is even less common. Although many treatment options exist, surgery is typically reserved for tumors significantly compressing surrounding structures. Pregnancy can complicate the management of these tumors, as fetal developmental considerations limit the ways in which they are imaged and treated. ⋯ While OPGs are typically benign tumors, pregnancy complicates their management significantly. Contrast media and anesthesia pose significant risks to the fetus, while pregnancy may contribute to increased rates of tumor growth and clinical deterioration. Managing OPGs in pregnant patients thus requires balancing the risks to the fetus and patient.
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To investigate the clinical effect and surgical techniques of fourth ventricle astrocytoma resection through the median suboccipital keyhole approach. ⋯ If appropriate microneurosurgical techniques are used via the median suboccipital keyhole approach, the fourth ventricle astrocytoma may be accessed and resected safely with shorter surgery time, reduced hemorrhage during operation, low incidence of postoperative complications, good recovery, and shorter hospitalization time.
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Neuronal apoptosis plays a pivotal role in spinal cord injury (SCI)-induced secondary cellular events. Caspase-dependent and -independent pathways are involved in neuronal apoptosis. Caspase-3 is the final effector of caspase-dependent apoptosis, whereas poly-ADP-ribose polymerase-1 (PARP-1) and apoptosis-inducing factor (AIF) are key executors of caspase-independent apoptosis. However, it remains unclear whether simultaneous inhibition of the 2 apoptosis pathways will be more beneficial for neuronal survival. Therefore, this study investigated the ability of coadministration of the PARP-1 inhibitor 3-aminobenzamide (3-AB) and caspase-3 inhibitor z-DEVD-fmk to attenuate apoptosis in a rat SCI model. ⋯ These results suggest that combination therapy is beneficial for neuronal function recovery in rats with SCI. The underlying mechanism may be associated with cosuppression of caspase-dependent and caspase-independent apoptosis pathways.
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We describe endovascular coil embolization of the internal carotid artery before removing a retained knife blade partially occluding the lacerum segment of the internal carotid artery. ⋯ A staged approach of digital subtraction angiography and endovascular therapy followed by surgical treatment is a safe and effective management strategy for patients presenting with a retained transcranial knife and suspected vascular injury.
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Posterior fossa dural arteriovenous fistulas are rare vascular malformations. If associated with cortical venous reflux, they present a significant risk of hemorrhage. We present a 54-year-old male who presented with progressive hearing loss without other neurologic symptoms. ⋯ Follow-up angiography 8 months later showed no evidence of residual/recurrent fistula. The patient's hearing improved. There were no adverse effects during the perioperative period.