World Neurosurg
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To describe three cases of delayed development of intracranial hypertension (IH) after surgical treatment of intracranial arachnoid cyst, including the pathogenesis of IH and a review of the literature. ⋯ The pathogenesis of delayed development of IH in this clinical setting is not clearly elucidated. When intracranial arachnoid cysts are treated, the possibility of future development of IH should be borne in mind. Delayed presentation with headaches in patients after treatment of intracranial arachnoid cysts should raise the possibility of IH.
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The prevalent method of ventriculostomy placement is via freehand insertion to cannulate the ventricle at a 90° angle to the skull to get ideal placement. Our goal was to test the validity of this practice in patients without midline shift and with normal ventricular size. ⋯ Our study concludes that not all catheters passed through Kocher's point using a perpendicular trajectory will end up in the ipsilateral frontal horn, and almost 10% of these catheters will be in a nonventricular space. In the instance in which a freehand pass fails to cannulate a ventricle, the safest alternative would be to make only minor adjustments to the perpendicular angle.
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Fluorescence-guided surgery for cranial meningioma has been reported to be useful. There are no reports about spinal cases using this technique. We report on a meningioma of the cervical spine for which fluorescence-guided surgery was used. ⋯ Fluorescence-guided microsurgery is helpful in achieving a total resection of spinal meningiomas, and might therefore reduce the risk of recurrence.
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Dural arteriovenous fistulas (DAVFs) are arteriovenous shunts from a dural arterial supply to a dural venous channel, typically supplied by pachymeningeal arteries and located near a major venous sinus. A retrospective review was conducted to present the results of endovascular obliteration of DAVFs, with particular emphasis of newer liquid embolic agents, including Onyx-18 (MV3, Irvine, California, USA). ⋯ Endovascular management of DAVFs is a safe and effective method of treating these complex lesions.
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At present there is no standard of care for patients with primary central nervous system lymphoma (PCNSL) because of the difficulty in delivering therapeutically effective doses of drugs to the intracellular site of the target PCNSL. Here we report the use of an iron oxide nanoparticle to promote the internalization of a PCNSL targeting antibody by target cells. ⋯ The high-degree specific binding and cell uptake of NP-FP in PCNSL suggests this NP formulation can be further developed to improve therapy of PCNSL.