World Neurosurg
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Review Meta Analysis
Perioperative complications and long-term outcomes after bypasses in adults with moyamoya disease: a systematic review and meta-analysis.
Surgical revascularization for adults with moyamoya disease (MD) includes direct, indirect, or combination bypasses. It is unclear which provides the best outcomes. We sought to determine the best surgical management for adults with MD by comparing perioperative complications and long-term outcomes among 3 bypass types. ⋯ Overall, our analyses suggest that direct bypass with or without indirect augmentation provides the best outcomes for adults with MD.
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Cranioplasty via use of the patient's autologous bone is performed often after craniectomy procedures. Bone resorption remains a matter of concern in patients with native bone cranioplasty. The objective of this study was to evaluate the rate of native bone resorption in adults and review associated factors that may increase the risk of resorption. ⋯ The rate of autologous bone flap resorption in adult patients undergoing cranioplasty is low even after a mean interval for cranioplasty of 6 months.
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Endoscopic versus stereotactic procedure for pineal tumour biopsies: focus on overall efficacy rate.
The management of pineal region tumors depends on the histologic subtypes. Two minimally invasive techniques are available: endoscopic intraventricular biopsies and stereotactic biopsies. The recent Southampton and Lille series are the largest endoscopic and stereotactic series of pineal region tumors reporting both diagnosis rate and accuracy rate, respectively; we elaborated on these results in the light of other recent studies. ⋯ The Southampton and Lille series provide a unique opportunity to compare the overall efficacy rates of endoscopic and stereotactic biopsies, respectively. The stereotactic approach is safer and more effective for biopsies of pineal region tumors. To improve the safety and reliability of endoscopic biopsies, various methods have to be evaluated: alternative burr-hole strategies, use of neuronavigation, and a combination of flexible and rigid endoscopes.
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Case Reports
Intradural Extramedullary Capillary Hemangioma in the Upper Cervical Spine: First Report.
The occurrence of intradural extramedullary capillary hemangiomas is exceedingly rare. To date, only 39 cases of intradural extramedullary capillary hemangiomas have been reported in the English literature, and all of these cases have been described at the lumbar and thoracic spinal levels. To our knowledge, this report is the first case of capillary hemangiomas of the cervical spine in the literature. In general, this entity is misdiagnosed preoperatively as a neoplasm. ⋯ Although rare, our case demonstrates that capillary hemangioma should be considered in the differential diagnosis of intradural extramedullary tumor of the cervical spine.