World Neurosurg
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This study aims to assess whether the A1 segment hypoplasia is a risk factor for unfavorable radiologic and clinical outcomes of surgical clipping anterior communicating artery (ACoA) aneurysm. ⋯ A1 segment hypoplasia is a significant independent risk factor for unfavorable clinical outcomes of surgical clipping ACoA aneurysm and ACA infarction after surgery.
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Conservative wait-and-scan management for vestibular schwannomas (VSs) is an important treatment option, but its role is unclear because of discordance between tumor growth and hearing outcomes. ⋯ Conservative management could be especially valid for small (<0.10 cm3), noncystic VSs in patients with Gardner-Robertson grade 1 at diagnosis. However, for tumors with a small-to-medium initial volume (0.10-3.0 cm3), future hearing impairment might be inversely proportional to tumor growth rate. Therefore, small-to-medium sized tumors should be followed-up more closely regardless of the initial hearing impairment.
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To investigate the relationships between upstream venous sinus stenosis and pulsatile tinnitus (PT), and to assess the correlation with diverticulum growth and the effectiveness of stent implantation. ⋯ Our findings strongly support a major role of diverticulum stenosis before in PT development and suggest that such stenosis is a causative factor of diverticulum growth. They also confirm the effectiveness of stent implantation for the treatment of PT.
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To evaluate results and feasibility of primary posterior reduction and fixation without fusion using C1-C2 screw-rod system for odontoid fractures. ⋯ Posterior reduction and fixation without fusion can be successfully performed for healing of odontoid fractures with acceptable results and minimal morbidity.
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The main target of stroke intervention is the revascularization of occluded vessels, usually achieved with thrombectomy or thrombus aspiration. Despite good results in limited series, intracranial primary stenting is controversial for increased hemorrhagic risk owing to the need for dual antiplatelet therapy. ⋯ Our experience with this patient demonstrates that primary intracranial stenting shoud be considered in selected cases when other revascularization techniques are difficult or impossible to perform owing to anatomic reasons. Extreme care should be taken in patient selection because of the risks associated with antiplatelet therapy. In particular, it may be recommended in patients with a small core on computed tomography perfusion or diffusion-weighted magnetic resonance imaging and in whom thrombectomy and thromboaspiration are impossible for anatomic reasons.