World Neurosurg
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Preserving the facial nerve (FN) during surgery for large vestibular schwannomas (VSs) is challenging because of the unpredictable locations and morphologic changes in the FN. Diffusion tensor imaging-based fiber tracking (DTI-FT) has been proposed to preoperatively visualize the FN. This study was performed to evaluate the efficacy of DTI-FT for predicting FN location and shape in patients with large VSs. ⋯ DTI-FT with modified tracking settings was useful to preoperatively predict the location of FN in patients with large VSs. The MFA of FN demonstrated moderate diagnostic performance for distinguishing compact from flat FNs.
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Selective tibial neurotomy (STN) was considered as an effective procedure for the treatment of spastic feet. It is also widely used for treating obese calves in some Asian countries. This study aimed to provide morphologic measurement data and theoretical support for the operation and intraoperative localization. ⋯ The calf circumference was positively related to the thickness of the soleus and the gastrocnemius. Diverging patterns of tibial nerve branches were multiple, and caution should be used to prevent damaging other branches. Tibial nerve, branches, and diverging sites could be seen clearly in the ultrasonic image. A preoperational ultrasonic examination is recommended.
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To study the craniovertebral junction and determine the anatomic characteristics of occipitalization of the atlas (OC) by computed tomography (CT) imaging. ⋯ The outlet of the foramen magnum is severely impaired in patients with OC, and the presence of other osseous anomalies is common. Deformity is not confined to the region of the assimilated atlas; the clivus and odontoid process are also shorter than normal. The lateral facet inclination likely influences disease progression.
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We describe our single-center experience treating unruptured brain arteriovenous malformations (uBAVMs) with microsurgical treatment. ⋯ Good functional outcome can be achieved by microsurgical resection in S-M grade I and II and selected grade III uBAVMs. Surgical resection for high-grade (grade IV and V) uBAVMs is challenging. A high seizure-free rate can be achieved in patients with initial seizure presentation.
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To evaluate the effects of vestibular schwannoma (VS) consistency on internal auditory canal (IAC) widening, magnetic resonance imaging appearance, presenting symptoms, and facial nerve outcome. ⋯ The consistency of VS has an impact on the immediate postoperative outcome. Widening on bony computed tomography scan, but not T2 intensity on magnetic resonance imaging, predicts whether the tumor is soft or firm.