World Neurosurg
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To corroborate which pretreatment angioarchitectural characteristics and posttreatment magnetic resonance imaging (MRI) features were associated with better seizure and antiepileptic drug outcomes in patients with brain arteriovenous malformations (AVMs) treated by Gamma Knife radiosurgery. ⋯ This study suggests that radiosurgery provides favorable outcomes in patients with AVM-related epilepsy. Patients with intracranial AVMs can benefit from seizure control after GKRS before undergoing AVM obliteration. Absence of retrograde veins is associated with better seizure-free outcomes, regardless of the parenchymal changes after radiosurgery.
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Traumatic odontoid fractures (tOFs) in the very elderly are associated with high morbidity and mortality. The best treatment strategy (conservative vs. surgery) is still unclear. ⋯ Our research was a retrospective cohort study, Level III.
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Case Reports
Neuroendoscopic Intraventricular Biopsy in Children with Small Ventricles using Frameless Varioguide® System.
Endoscopic biopsy for intraventricular tumors in pediatric patients with small ventricles is a challenging procedure because of the risk of morbidity during the intraventricular approach. We describe the use of the VarioGuide system for intraventricular endoscopic biopsy in 9 consecutive pediatric patients with intraventricular lesions and small ventricular size. All patients had lesions in the anterior part of the third ventricle with a median frontal and occipital horn ratio of 0.33. ⋯ Diagnoses included germinomas in 4 patients, hamartoma in 1 patient, hypothalamic astrocytoma in 2 patients, and craniopharyngioma in 2 patients. The use of the VarioGuide system for intraventricular endoscopic biopsy is highly recommended for pediatric patients with small ventricle size. This technique may help minimize the risk of unnecessary brain damage during the entrance to small ventricles.
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Intracranial aneurysms constitute a significant part of the caseload for any neurosurgical service. Despite the occurrence of intracranial aneurysms and the availability of advanced diagnostic tools and management options, there is a paucity of published data concerning aneurysm patterns in Kenya. ⋯ Most patients were postmenopausal women, who had a higher rate of aneurysms with an elevated risk of rupture for small aneurysms; this suggests that clinicians need to be more vigilant and have a higher index of suspicion in such patients with subtle clinical signs. This study revealed a pattern of aneurysms in accord with previous reports and is expected to serve as a basis for further research on aneurysm management, outcome, and prognostic indicators in the Kenyan population.
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This prospective cohort-designed study was performed to verify whether higher levels of serum lipoprotein(a) (Lp(a)) could be a risk factor for deep vein thrombosis (DVT) in Chinese patients with spinal cord injuries (SCI). ⋯ Increased serum Lp(a) levels were independent predictors of DVT in patients with SCI in China, suggesting a possible role of Lp(a) in the pathogenesis of DVT.