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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The aim of this study was to identify the risk factors for subsequent hemorrhage in patients with untreated cerebellar arteriovenous malformations (AVMs). ⋯ Childhood at diagnosis, large AVM size, and AVMs with exclusively deep venous drainage are independent risk factors for subsequent hemorrhage in patients with cerebellar AVMs. Previous rupture may increase the hemorrhagic risk during the first 5 years after diagnosis but may not significantly increase the risk in the following years.
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To highlight the management nuances in addressing mirror aneurysms (MirAns) in a subset of multiple aneurysms. ⋯ MirAns are not significantly associated with risk factors such as age, hypertension, and diabetes. Intraoperative rupture, vasospasm, and infarct are less common, with a tendency towards better neurologic outcome compared with nMirAns.
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The Rhoton Collection is an archive of Dr. Al Rhoton Jr.'s anatomical images and video lectures, as well as an anatomical reference. ⋯ Surgical cases are cross-referenced to further enhance the usefulness of this collection, which is available at http://rhoton.ineurodb.org. The features of the Rhoton Collection website are described in this article.
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Although targeted by radiotherapy, recurrence in glioblastoma occurs mainly periresectionally owing to tumor infiltration. An increase in the apparent diffusion coefficient (ADC) has been shown in the large high-T2 area on magnetic resonance imaging posttreatment; however, until now ADC has not been investigated directly in the more relevant periresectional area. ⋯ Increased ADC values, representing a decrease in infiltrative tumor load, were demonstrated in a limited direct periresectional area. This finding adds to previous studies evaluating ADC response in the larger high-T2 area in relation to survival.