World Neurosurg
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Although there are many reports on the efficacy of preoperative embolization for meningioma, such as a reduction in intraoperative blood loss, its efficacy for vestibular schwannoma remains unclear. Feeding arteries of vestibular schwannomas include branches from the anterior inferior cerebellar artery and internal carotid artery, in addition to the branches from the external carotid artery (ECA). However, it has been reported that the embolization of feeding arteries from the anterior inferior cerebellar artery and the internal carotid artery has a high risk of complications. Therefore, we retrospectively analyzed the effects of preoperative embolization of only the feeding arteries from the ECA for vestibular schwannomas, particularly regarding its volume reduction effect. ⋯ Preoperative embolization of only the feeding arteries from the ECA may be an effective adjunctive treatment for vestibular schwannomas, given the significant volume reduction effect achieved within several days after embolization, in addition to reducing intraoperative blood loss.
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The management of multiple intracranial aneurysms poses a significant clinical challenge.1 Various factors, including the patient's neurologic status, age, risk factors, aneurysm morphology, location, ruptured or unruptured status, availability of equipment, the surgeon's surgical abilities, and patient preferences, influence the choice of treatment modality.2 It has been observed that there is a higher risk of rupture during the perioperative period when surgical intervention is performed to treat a ruptured aneurysm.3 Additionally, it is suggested that patients with multiple aneurysms located in both the anterior and posterior circulation are less likely to be treated with a single procedure.4 This surgical strategy should be applied in the setting of multiple aneurysms in the anterior and posterior circulation that would, on the other hand, demand multiple interventions.5 In an experienced scenario, microsurgery could be a viable option. We present the case of a 58-year-old patient who presented with chronic headaches, a medical history of hypertension, and tobacco use. The patient had no neurologic deficits. ⋯ The patient consented to the procedure and publication of her image. No institutional research ethics board approval was required because only intraoperative footage was shown. No identifiable data are displayed except for 2 photographs of the patient's head without the face, which was appropriately consented to.
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Despite its association with lower survival rates among patients in various disease states, financial toxicity is often overlooked in health care. The aims of our study are to elucidate the effect of financial toxicity on the care of glioma patients. ⋯ Our results suggest there is a strong association between financial toxicity, socioeconomic status, and the standard of care following GBM resection. They also shed light on the financial toxicities associated with the care of these patients.
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This retrospective cohort study aimed to evaluate the effectiveness of posterior long-segment fixation for thoracolumbar osteoporotic vertebral compression fractures (TLOVCFs) and identify prognosis-predicting factors. ⋯ Posterior long-segment fixation effectively improved kyphotic deformity and provided stable outcomes in patients with TLOVCFs. Open screw fixation offered better maintenance of correction with a lower risk of screw loosening compared to percutaneous methods. Therefore, further prospective studies are necessary to establish standardized treatment protocols for TLOVCFs.
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The purpose of this study was to investigate whether the preservation of the anterior edge of the vertebral body affects the cage subsidence and clinical outcomes after anterior cervical discectomy and fusion (ACDF) using zero-profile cages. ⋯ For patients who undergo ACDF with zero-profile cages, especially those with a higher surgical segment, bone protection at the anterior edge of the vertebral body can effectively reduce the risk of zero-profile cage subsidence, but there is no difference in the final clinical effect.