World Neurosurg
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Pediatric high-grade brainstem gliomas are aggressive tumors with dismal prognoses. Large-scale studies are needed to further characterize these tumors and determine factors influencing cancer-specific mortality and survival at varying time points. ⋯ This population-based study showed that glioblastoma histology is associated with a poor prognosis in pediatric patients with high-grade brainstem gliomas. Regardless of histology, radiation therapy improved survival at 6 and 9 months but not long-term.
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Traumatic brain injury (TBI) is a devastating neurologic injury and remains a major cause of death in the world. Secondary injury after TBI is associated with long-term disability in patients with TBI. This study evaluated adrenomedullin (AM) on secondary injury and neurologic functional outcome in rats after TBI. ⋯ AM can improve neurologic function and ameliorate brain injury in rats with TBI. AM exerts its neuroprotective effect via its anti-inflammatory and antiapoptotic effect.
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Advanced magnetic resonance imaging (MRI) acquisition methods such as 4D phase contrast magnetic resonance imaging (4D pcMRI) have found widespread applications in assessing hemodynamics in cerebral aneurysms. One of the goals is the identification of a hemodynamic scenario predictive of aneurysm rupture. Because of the technical complexity the 4D pcMRI technology, challenges exist in extracting and communicating the wealth of information contained in the MRI image data, in particular, to a multidisciplinary team of health professionals and basic scientists. ⋯ Augmented reality may become an additional means for visualizing complex medical data, in particular complex flows as illustrated here.
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Endoscopic third ventriculostomy (ETV) remains the mainstay of treatment for noncommunicating hydrocephalus these days. However, there has been no adequate clue for the intraoperative assessment of ETV efficacy until now. This time, we propose a newly defined finding, "folding sign," which is visible and enables us to confirm penetration of both the third ventricle floor and the Liliequist membrane (LM) during operation. In this report, we describe consecutive ETV cases and discuss the mechanism of folding sign and its clinical meanings. ⋯ The folding sign is a newly defined sign to predict the success of ETV during operation. This optimal finding appears only when the LM is sufficiently opened; therefore, it could be a good candidate for an intraoperative assessment tool.
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The greater auricular nerve (GAN) may be used as a nerve graft during neurosurgical procedures to repair damaged nerves. There is extensive literature on localization of the GAN at the posterior triangle of the neck, but objective information on localization of the GAN at the anterior triangle of the neck close to cranial neurosurgical fields is lacking. The aim of this study was to introduce simple and reliable landmarks to localize the GAN at the anterior triangle of the neck to facilitate its harvest during neurosurgical procedures. ⋯ The AGA point and the M-A line are reliable landmarks for locating the GAN at the anterior triangle of the neck and for helping neurosurgeons expose and harvest the GAN efficiently.