Neurosurgery
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Resection of the anterior clinoid process (ACP) for the clipping of an internal carotid-posterior communicating artery aneurysm is rarely needed. However, preoperative awareness of the necessity of anterior clinoidectomy is essential for safe clipping of the lesions. We investigated the preoperative predictive value for anterior clinoidectomy in treating internal carotid-posterior communicating artery aneurysms. ⋯ The anterior clinoidectomy group showed a more tortuous course of intracranial ICA around the ACP than the nonclinoidectomy group. Therefore, measurement of the distal ICA angle is helpful in predicting the necessity of anterior clinoidectomy.
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Management options for patients with vestibular schwannoma include observation, surgical resection, stereotactic radiosurgery (SRS), and stereotactic radiation therapy. In younger patients, resection is often advocated because of concern regarding the long-term effects of radiation. We studied tumor response and clinical outcomes after SRS in such patients. ⋯ Our experience indicates that GK SRS is an effective management strategy for younger patients with vestibular schwannoma, most of whom have no additional cranial nerve dysfunction.