World Neurosurg
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To summarize the experience in microsurgical resection of cervical spinal cord arteriovenous malformation (AVM). ⋯ Microsurgical resection of cervical intramedullary AVMs has obtained satisfactory clinical results. Preoperative magnetic resonance angiography, computed tomography angiography, and digital subtraction angiography are useful for evaluating the angioarchitecture, which is key to the success of surgery. Intraoperative indocyanine green fluorescence angiography is an important aid in the surgical treatment of spinal AVMs.
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Intradural extramedullary spinal teratoma (IEST) is a rare condition in adults, with a male predominance. It is commonly associated with spinal dysraphism, lumbar puncture, and previous spinal surgery. This case is a 37-year-old male diagnosed with a mature cystic IEST without dysraphism or previous surgical interventions. ⋯ MRI is a standard tool for diagnosing IEST, but the diagnosis is confirmed by histopathological examination. Total surgical excision is the treatment of choice, but when adhesions to the neural tissue are present, subtotal excision should be attempted. The patient should be followed up with serial clinical and radiologic examinations to ensure the absence of residual mass at the site of surgery.
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Flow diversion with the Pipeline Embolization Device (PED) currently is adopted for treatment of a variety of intracranial aneurysms. The elevated risk of thromboembolic complications associated with the device necessitates the need for administration of antiplatelet agents. We sought to assess current dual-antiplatelet therapy practices patterns and their associated costs after PED placement. ⋯ Significant heterogeneity in dual-antiplatelet regimens after PED placement and associated costs exists at major academic neurovascular centers. The most commonly used first-line dual-antiplatelet regimen consists of aspirin and clopidogrel. Two major alternate protocols involving ticagrelor and prasugrel are administered to clopidogrel hyporesponders. The optimal dual-antiplatelet regimen for patients with cerebrovascular conditions has not been established, given limited prospective data within the neurointerventional literature.
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Observational Study
Primary hemorrhagic neurovascular diseases (PHNVDs) in Tibetans: a retrospective observational study.
Although there have been many studies on primary hemorrhagic neurovascular diseases (PHNVDs) in different populations, a study focusing on PHNVDs in Tibetan people was lacking. This study aimed to explore the notable characteristics of Tibetan PHNVDs by comparing the 3 most common PHNVDs (aneurysmal subarachnoid hemorrhage, spontaneous intracerebral hemorrhage, and arteriovenous malformation) in our institution between Tibetan and Han patients. ⋯ For Tibetan PHNVDs, a high incidence of BLAs in aneurysmal subarachnoid hemorrhage, a tendency toward brainstem hemorrhage in subtentorial spontaneous intracerebral hemorrhage, and a high rate of infarction and rebleeding in all 3 subtypes were all recognized.
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Cell therapy is configured as a promising strategy for the treatment of spinal cord injury (SCI), but it requires reliable systems to achieve microinjections with different rates and volumes, according to the different characteristics of the injured spinal cord tissue and the targets previously selected. ⋯ We have described an original attachment device for the support of a microinjection pump. It is applicable to spinal cord surgery and should be considered as a cheap solution for intralesional administration of cell therapy after spinal cord injury.