World Neurosurg
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The use of Gamma Knife radiosurgery (GKRS) for recurrent or residual vestibular schwannoma (VS) after microsurgery (MS) has been investigated in several retrospective studies. The purpose of this study was to identify potential risk factors for both neurologic deterioration and tumor progression after GKRS for previously operated VSs in a prospective setting. ⋯ Intended submaximal resection followed by GKRS is a viable treatment for VS. Because tumor remnant size after MS is an important predictor for recurrence after adjuvant GKRS, both brainstem and cerebellar decompression and maximal safely achievable resection should remain major goals of microsurgery.
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The purpose of this study was to analyze the outcomes of cavernous sinus hemangiomas (CSHs) treated surgically, and to investigate factors that affect the gross total resection (GTR), newly developed or deteriorated cranial nerve injury (NDDCNI), and follow-up neurologic performance, and to further discuss the optimal treatment for CSHs. ⋯ Being treated by an experienced skull base surgeon favors the total removal of CSHs, whereas the invasion of the sella turcica does just the opposite. Increased tumor size is a risk factor for unfavorable follow-up KPS score. The invasion of the sella turcica was related to NDDCNI and unfavorable follow-up KPS score.
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To determine the effectiveness of basal membranotomy performed to ensure cerebral expansion in patients operated for chronic subdural hematoma. ⋯ The mini craniotomy-basal membranotomy technique provided statistically significantly better cerebral expansion in patients with chronic subdural hematoma when compared with the double burr hole drainage technique.
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To investigate the relationships between sagittal alignment parameters and Neck Disability Index (NDI) scores after adjacent 2-level anterior cervical diskectomy and fusion (ACDF) and to study the impact of the T1 slope (T1s) minus C2-7 lordosis (T1s-CL). ⋯ Changes in cervical sagittal parameters after 2-level ACDF were associated with quality of life. A greater T1S-CL mismatch was related to a greater degree of cervical malalignment. T1s-CL may be a more important predictor of cervical malalignment than C2-7 SVA. Specifically, a mismatch greater than 28.07 corresponded to positive cervical sagittal malalignment, defined as an NDI score greater than 25.