World Neurosurg
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There is accumulating evidence that extent of resection (EOR) in intrinsic brain tumor surgery prolongs overall survival (OS) and progression-free survival (PFS). One of the strategies to increase EOR is the use of intraoperative MRI (ioMRI); however, considerable infrastructure investment is needed to establish and maintain a sophisticated ioMRI. We report the preliminary results of an extraoperative (eoMRI) protocol, with a focus on safety, feasibility, and EOR in intrinsic brain tumor surgery. ⋯ An eoMRI protocol appears to be a safe and practical method to ensure maximum safe resections in patients with brain tumors and can be performed readily in all centers with MRI capabilities.
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Our objective was to analyze the relevance, potential prognostic factors, and complications of endoscopic third ventriculostomy (ETV) in patients with shunt failures. ⋯ This study confirms that ETV should be considered as the first therapeutic option before shunt revision in cases of initial obstructive hydrocephalus.
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To perform a retrospective chart review of surgically treated patients with spinal dural arteriovenous fistula (SDAVF), a rare disease but the most common vascular malformation of the spine, focusing on clinical characteristics and functional outcome during long-term follow-up. ⋯ Surgical treatment of SDAVFs is safe and effective and leads to an improvement of neurologic symptoms in most patients. Surgical treatment of SDAVFs also provides long-term stability.
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Vestibular schwannomas (VSs) are benign, slowly growing tumors. The management strategy, however, remains unclear for both primary VS and remnant VS after subtotal or partial resection. In this study, we analyzed the radiographical tumor growth to elucidate factors possibly predicting growth or regrowth of their tumors. ⋯ Small remnant VS after surgery could be conservatively managed without additional treatment, and relatively large remnant VS should be followed up with close serial imaging or might be a possible candidate for radiosurgery during the early postoperative period.
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Bifrontal craniotomy is effective for the treatment of anterior skull base lesions. However, the frontal sinus (FS) is often opened during this surgery, and various postoperative complications may occur as a result of the open FS, including cerebrospinal fluid leakage and infection. We describe our procedure for maintaining the patency of the nasofrontal duct and direct suture of the exposed and violated FS mucosa. ⋯ The present results indicate the effectiveness of our technique for the prevention of FS-related postoperative complications.