World Neurosurg
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The prognosis of unruptured giant basilar artery (BA) aneurysms is very poor. No treatment has shown efficacy in survival. This pilot case-control study examines the overall survival (OS) benefit of combined surgical and endovascular management of giant BA aneurysms. ⋯ Our study suggests that preventive posterior fossa craniectomy increases significantly OS of patients with giant BA aneurysms.
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Case Reports
Full-endoscopic transforaminal approach for removal of a spontaneous spinal epidural hematoma: A case report.
The incidence of spinal epidural hematoma (SEH) is estimated to be 1 per 1,000,000 patients per year; SEH can be classified as idiopathic, spontaneous, and secondary. The cause of spontaneous SEH is uncertain but it may be associated with minor trauma. SEH can compress surrounding structures, shown by clinical symptoms and signs that affect the spinal cord or nerve roots. Surgical treatment may be considered if medical treatment fails. ⋯ Spontaneous SEHs are uncommon. Although lumbar laminectomy is the mainstream treatment in those with neurologic deficits caused by epidural hematomas, the percutaneous full-endoscopic transforaminal approach may be an option for certain SEHs.
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Intraoperative identification of cranial nerves is crucial for safe surgery of skull base tumors. Currently, only a small number of published papers describe the technique of trigger electromyography (t-EMG) in endoscopic endonasal removal of such tumors. ⋯ t-EMG allows surgeons to control the safety of cranial nerves both during and after skull base tumor removal.
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The carotid web is an intraluminal shelf-like projection arising from the posterior wall of the carotid bifurcation and an uncommon etiology of ischemic strokes. We describe the feasibility of endovascular stent placement to treat this condition. ⋯ Carotid artery stent placement is a feasible option in the management of carotid webs.
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To report the surgical outcome of very small intracranial aneurysms (VSIAs; ≤3 mm) in a large referral neurovascular center in Southern Iran. ⋯ Surgical clipping of ruptured and unruptured VSIAs is a safe and effective modality of treatment associated with low mortality and morbidity. Age, comorbidities (hypertension, ischemic heart disease), GCS score on admission, Hunt and Hess grade, preoperative ventriculoperitoneal shunt insertion, and subarachnoid hemorrhage are important predictors of outcome in patients with VSIAs undergoing surgery.