World Neurosurg
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Treatment of complex unruptured middle cerebral artery (MCA) aneurysms that are untreatable with conventional surgical techniques are rare, and direct aneurysmal clipping usually remains the first-line treatment for large and giant saccular MCA aneurysms. Tandem clipping and multiple clipping techniques represent neck reconstruction in direct clipping surgeries that address these aneurysms. ⋯ "Mass reduction" clipping, which changes the shape of the aneurysm and reduces the size of the whole aneurysmal mass, is a useful variation for the treatment of large aneurysms when conventional clipping across the neck is feasible.
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To explore the efficacy and safety of Gamma Knife radiosurgery (GKRS) for meningiomas in patients with neurofibromatosis type 2 (NF2). ⋯ GKRS represents an effective and safe management strategy with minimal invasion for patients with NF2-associated meningiomas. Our data showed a high local control rate of NF2-associated meningiomas by GKRS; however, the distant control rate is low, especially in young patients. For these patients, retreatment with GKRS may still be the advisable method.
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Self-locking stand-alone cages can achieve satisfactory clinical results and fusion rate. However, there have been no reports on the causes and relationship of different fusion state. This study is to classify the different fusion states of the index level and to explore the potential contributing factors and links of them. ⋯ For anterior cervical discectomy and fusion with self-locking stand-alone cages, the fusion of the index level seems to be a progressive dynamic process during the mid-term follow-up, which may be influenced by the location of the cage, the aagittal vertical axis of the index level, and the global range of motion of the cervical spine. Satisfactory clinical results could be achieved by all the fused types.
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We sought to clarify the expression characteristics and prognostic significance of transforming growth factor (TGF)-β3 in cranial meningiomas. ⋯ TGF-β3 expression levels gradually declined with the increase of WHO grade and were lower in recurrent meningiomas than in primary meningiomas. Besides, low TGF-β3 expression was found to predict tumor recurrence and mortality in meningiomas based on univariate analysis.
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The overall survival rates for breast cancer are increasing due to controlled brain disease and improved systemic treatments. This study examined neurologic outcomes, tumor control, and survival data in breast cancer patients with multiple brain metastases and who required salvage stereotactic radiosurgery (SRS) for recurrent breast cancer brain metastases. ⋯ This report indicated that both initial and salvage SRS procedures in breast cancer patients with multiple brain metastases are effective for local control of intracranial disease while minimizing adverse radiation effects.