World Neurosurg
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The coexistence of a primary brain tumor such as high-grade glioma and superimposed abscess is a rare entity and can present a diagnostic and therapeutic challenge. The concomitant abscess may not be recognized until surgery, and the overall course of treatment may require adjustment in the presence of a coinciding infection. In the present report we evaluate the diagnosis and treatment of a glioblastoma multiforme with an intratumoral abscess. ⋯ There are insufficient guidelines on the treatment of a primary brain tumor with intratumoral abscess. In this report we present our therapeutic decisions in this rare case.
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To create a simple artificial neural network (ANN) to predict the occurrence of symptomatic cerebral vasospasm (SCV) after aneurysmal subarachnoid hemorrhage (aSAH) based on clinical and radiographic factors and test its predictive ability against existing multiple logistic regression (MLR) models. ⋯ A simple ANN model was more sensitive and specific than MLR models in prediction of SCV in patients with aSAH. The conception of ANN modeling for cerebral vasospasm is introduced for a neurosurgical audience. With advanced ANN modeling, the clinician may expect to build improved models with more powerful prediction capabilities.
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This report presents 12 consecutively managed patients with aneurysmal subarachnoid hemorrhage (SAH) associated with acute subdural hematoma (ASDH) who underwent decompressive craniectomy (DC) with special attention to their clinical characteristics and surgical outcomes. ⋯ We suggest that the DC was effective for reducing morbidity and mortality in poor grade patients with SAH presenting with ASDH.
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Conventional surgical treatment of bilateral ophthalmic aneurysms would require bilateral craniotomies and bilateral neck dissections for proximal control of the cervical internal carotid artery (ICA). We present a semiemergent case where bilateral ophthalmic artery aneurysms were clipped using a unilateral mini-pterional craniotomy and contralateral proximal cervical ICA control while employing the Sugita head frame. ⋯ Our case illustrates safety and control while clipping bilateral ophthalmic artery aneurysms via a unilateral mini-pterional approach and utility of the Sugita head frame.
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To apply a three-dimensional geometric model to various endoscopic endonasal approaches to analyze the bony anatomy of this area, quantify preoperatively bone removal, and optimize surgical planning. ⋯ Aside from laboratory anatomic dissection itself, this model is very effective in providing a depiction of bony landmarks and visual feedback of the amount of bone removed, improving the design of the craniectomy in the endoscopic endonasal midline skull base approach.