World Neurosurg
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Multicenter Study
Fluorescein-guided resection of intramedullary spinal cord tumors: results from a preliminary, multicentric, retrospective study.
Intramedullary spinal cord tumors (IMSCTs) are rare, heterogenous lesions that are usually enhanced on preoperative magnetic resonance imaging (MRI) because of a damaged blood-brain barrier. Sodium fluorescein is a dye that accumulates in areas of the central nervous system with a damaged BBB. Given the pattern of MRI contrast enhancement of the majority of IMSCTs, the use of this fluorescent tracer could improve tumor visualization and quality of resection. In this article, we present the first experience with the application of fluorescein-guided technique for surgical removal of IMSCTs. ⋯ Our results suggest that fluorescein-guided surgery is a safe and effective technique that can be used during the surgical resection of IMSCTs presenting with contrast-enhancement on preoperative MRI.
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Review Case Reports
Staged Trapping of Traumatic Basilar Trunk Pseudoaneurysm: A Case Report and Review of Literature.
Traumatic intracranial aneurysms (TICAs) of the posterior circulation in the pediatric populations are rare. Only a few reports in the literature document basilar artery TICA in the pediatric population. These cases were typically associated with a clival fracture and commonly diagnosed weeks to months after trauma. We present a case of a patient with a basilar TICA diagnosed after a motor vehicle collision treated with staged trapping and review of the literature. ⋯ Development of a TICA may be more acute than literature previously suggested. Treatment consists of a wide range of options and should be considered, especially in the pediatric population, to prevent rupture. Trapping can be performed safely if adequate collateral flow is present in the setting of a large basilar artery aneurysm.
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To review the complex pathogenesis of the subdural membrane and the link between head trauma, dementia, and dural lymphatics. ⋯ Further research into the possible link between traumatic brain injury and cSDH in particular and dural lymphatics and intracranial fluid dynamics is warranted.
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Review Case Reports
Long-term patency of posterior auricular artery-middle cerebral artery bypass for adult-onset moyamoya disease: case report and review of literature.
Direct extracranial-intracranial (EC-IC) bypass is one of the fundamental techniques to prevent recurrent stroke in patients with adult-onset ischemic moyamoya disease. When the standard superficial temporal artery (STA) cannot be used for a graft, the posterior auricular artery (PAA) can be a potential surrogate graft. ⋯ In conclusion, the PAA becomes a potential donor for EC-IC bypass as long as its diameter is approximately 1.0 mm. Even though the PAA-MCA bypass is not primarily considered in the initial revascularization, it can be useful as a combination bypass with other grafts or as a rescue for recurrent ischemia.
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Supratentorial arteriovenous malformations (AVMs) are heterogeneous pathologic entities and require an intricate decision-making process for their management. We present 3 cases of supratentorial arteriovenous malformations with diverse clinical presentations and highlight the role of microsurgical resection in present-day multimodality treatments of arteriovenous malformations.