World Neurosurg
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Classic three-dimensional schemas of the internal carotid artery (ICA) for transcranial approaches do not necessarily apply to two-dimensional endoscopic views. Modifying an existing ICA segment classification, we define endoscopic orientation for the lacerum (C3) to clinoid (C5) segments through an endonasal approach. ⋯ Distinguishing which ICA type courses between the lacerum and clinoid segments can help clarify the relationships between the artery and its surrounding structures during endoscopic approaches. Adapting the classic terminology of ICA segments provided consistency of endoscopic relevance, defined potential endoscopic corridors, and highlighted the critical step of arterial contact.
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Sarcoma rarely metastasizes to the brain, and there are no specific treatment guidelines for these tumors. The recursive partitioning analysis (RPA) classification is a well-established prognostic scale used in many malignancies. In this study we assessed the clinical characteristics of metastatic sarcoma to the brain and the validity of the RPA classification system in a subset of 21 patients who underwent surgical resection of metastatic sarcoma to the brain ⋯ This analysis is the first to support the prognostic utility of the Radiation Therapy Oncology Group RPA classification for sarcoma brain metastases and may be used as a treatment guideline tool in this rare disease.
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Validity of prognostic grading indices for brain metastasis patients undergoing repeat radiosurgery.
We tested the validity of 5 prognostic indices, Recursive Partitioning Analysis (RPA), Score Index for Radiosurgery (SIR), Basic Score for Brain Metastases (BSBM), Graded Prognostic Assessment (GPA), and Modified-RPA, for patients who underwent repeat stereotactic radiosurgery (re-SRS). ⋯ Among the 5 systems, based on patient number proportions, MST separation among the 3/4 groups, and/or detailed reflection of status changes, the Modified-RPA system was shown to be most applicable to re-SRS patients.
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The aim of the study was to examine the correlation between various morphometric factors of the posterior circulation aneurysms and the severity of neurologic status and radiologic extent of subarachnoid hemorrhage. ⋯ Inflow angle and SR were found to be correlated with grading in FRS, and WFNS scale was correlated with inflow angle.
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Given their location and slow growth, olfactory groove and planum sphenoidale meningiomas often grow to large sizes before they present with clinical symptoms and pose significant surgical challenges. The goal of our study is to identify which preoperative symptoms and findings on magnetic resonance imaging are correlated with specific postoperative outcomes in order to better counsel patients preoperatively. ⋯ We conclude that tumors larger than 3.4 cm in diameter and those whose posterior edge is within 6-8 mm of the optic chiasm should be recommended for early surgical intervention. In terms of predicting surgical complications, nasal sinus invasion and anterior cerebral artery encasement are associated with greater-risk profiles when surgery becomes necessary. Thus, it is prudent to take these specific variables into consideration when advising patients about the risks of observation and surgery for olfactory/planum meningiomas.