Neurosurgery
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Evaluation of differences in neuropsychological outcomes in patients undergoing surgical clipping (SC) vs endovascular coiling (EC) for unruptured cerebral aneurysms is essential in guiding patients seeking treatment of asymptomatic cerebral aneurysms. ⋯ Whereas the initial decline in neuropsychological functioning was greater for SC patients, 1 yr after treatment there was no significant difference in neuropsychological outcome among the SC, EC, and healthy control groups.
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Liposclerosing myxofibrous tumors (LSMFTs) are rare benign fibro-osseous tumors most frequently occurring in the proximal femur. We report the first case of this rare tumor occurring within the calvarium. ⋯ LSMFT is a rare tumor that should remain on the differential for lesions of the calvarium. When diagnosed, this lesion can be removed with the goal of gross total resection and excellent cosmesis can be achieved.
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Hemodynamic factors play a crucial role in the recurrence of intracranial aneurysms after coiling. However, the strongest factor for predicting recurrence remains unclear because each risk factor has been investigated and reported separately. ⋯ The pressure difference in the virtual postcoiling model may be a strong predictor of recurrence after coiling.
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Please see the full-text version of this guideline https://www.cns.org/guidelines/guidelines-treatment-adults-metastatic-brain-tumors/chapter_2) for the target population of each recommendation listed below. SURGERY FOR METASTATIC BRAIN TUMORS AT NEW DIAGNOSIS QUESTION: Should patients with newly diagnosed metastatic brain tumors undergo surgery, stereotactic radiosurgery (SRS), or whole brain radiotherapy (WBRT)?
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Image guidance is a promising technology that could lead to lower rates of premature shunt failure by decreasing the rate of inaccurate proximal catheter placement. ⋯ Electromagnetic neuronavigation results in more accurate placement of catheters, but did not result in an overall reduction in proximal shunt failure at 90 and 180 days after the index surgery. However, subgroup analysis suggests a clinically important benefit in those patients with harder to cannulate ventricles.