World Neurosurg
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Abnormalities of the posterior arches of the upper and middle cervical spine that can cause myelopathy are rare, and no reports of such defects at the thoracic spinal level have been published. ⋯ A posterior arch defect of the upper and middle cervical spine leading to myelopathy combined with the same defect at the thoracic spine is a rare disease. If this congenital defect is detected at any spinal level, whole-spine CT can be helpful for accurately diagnosing the congenital anomaly.
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As one subtype of meningiomas, chordoid meningiomas (CMs) are rarely described. In this study, the authors aimed to analyze the incidence, clinical features, treatment, and prognostic factors of CMs. ⋯ CM is a rare subtype of World Health Organization grade II meningioma. It more frequently involved the adult patients and was without sex predilection. The confirmed diagnosis relied on pathological validation. Total resection whenever possible is recommended to prolong PFS of patients. The value of adjuvant radiotherapy for CM need to be further studied.
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The nasoseptal flap (NSF) has been shown to be a mainstay in the reconstruction of skull base defects. We evaluated the efficacy and complications of NSF in patients with a history of septal surgery who had the potential risk of tearing and poor vascularity. ⋯ There was no difference in rate of CSF leakage or flap integrity between the 2 groups. Therefore, NSF for skull base reconstruction is feasible in patients with a history of septal surgery.
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Pituitary carcinoma is defined by either metastases outside the central nervous system or noncontiguous foci within the central nervous system. This case report details the first documented case of a pathologically isolated follicle-stimulating hormone-secreting pituitary carcinoma and its presentation of metastasis. ⋯ Although rare, metastatic spread is recognized in patients with atypical pituitary adenoma. This should form the differential diagnosis for such patients presenting with symptoms that could be attributed to metastatic lesions within the neuraxis. In these patients, who undergo regular surveillance in joint neuroendocrine clinics, more urgent investigation of new spinal pain should be instigated to exclude metastatic disease.
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Although age already is known as a crucial factor affecting the functional outcome after a hemicraniectomy for malignant hemispheric infarction, previous studies have used arbitrary age cut-offs of 50, 60, or 70 years. Therefore, this study investigated predictors of the functional outcome after a hemicraniectomy and attempted to determine the critical age for an unfavorable functional outcome. ⋯ Advanced age was identified as a significant predictor of an unfavorable outcome and functional dependency. The PPV of a patient age >58 years and >67 years for predicting an unfavorable outcome with functional dependency was 82% and 100%, respectively.