World Neurosurg
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Hypertrophic neuropathy is a rare entity commonly associated with peripheral nerve, characterized by onion bulb formations. Its cranial nerve involvement is very rare; only 7 cases have been found in the literature. ⋯ Here, we report a first case of isolated hypertrophic neuropathy involving the oculomotor nerve.
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Randomized allocation of treatment options is not well accepted within the clinical community. Some methods of implementation may be received more favorably than others. Prerandomization may be an acceptable means to facilitate recruitment in some clinical trials. ⋯ Until the ethical functions of randomized allocation of selected treatment options in the care of patients are recognized by the neurovascular community, Zelen's prerandomization may help recruitment into difficult trials and contribute a means to provide best possible care in the presence of uncertainty.
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Diffusion tensor imaging-based navigation is unable to resolve crossing fibers or to determine with accuracy the fanning, origin, and termination of fibers. It is important to improve the accuracy of localizing white matter fibers for improved surgical approaches. We propose a solution to this problem using navigation based on track density imaging extracted from high-definition fiber tractography (HDFT). ⋯ DSI-based TDI navigation allows for the visualization of anatomic features such as fanning and angling and helps to identify the range of a given tract. Moreover, our results show that our HDFT navigation method is a promising technique that preserves neural function.
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Among the rare intraventricular cavernomas, purely intra-aqueductal cavernomas are exceptionally rare. ⋯ We discuss the rationale that led us to treat hydrocephalus with neuroendoscopy, which offered the possibility to directly inspect the intra-aqueductal lesion, make the diagnosis of cavernoma, and treat symptoms resulting from hydrocephalus without increasing the risk of bleeding.
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Pseudoaneurysms of scalp arteries have been reported in rare cases after iatrogenic injury; however, they are far more commonly seen after traumatic injuries. They are usually associated with the superficial temporal artery; however, there have been a few reports of psuedoaneurysms of the occipital artery (OA). ⋯ The patient recovered fully after endovascular embolization. Other treatment options for pseudoaneurysms of facial, temporal, and scalp arteries include surgical clipping/trapping with excision, Hunterian ligation, or direct compression. Pseudoaneurysms of extracranial scalp arteries are rare and most often caused by traumatic compression of the artery against a bony ridge. Despite their rarity, pseudoaneurysms secondary to iatrogenic injury to extracranial arteries should be considered in the differential diagnosis in patients presenting with delayed incisional pain, redness, and swelling.