World Neurosurg
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Treatments for intracranial aneurysms mainly include endovascular treatment and craniotomy. Most studies report on large intracranial aneurysms, yet treatments for very small intracranial aneurysms remain controversial. Our purpose was to explore management strategies for ruptured very small intracranial aneurysms. ⋯ Endovascular therapy for ruptured very small intracranial aneurysms was not inferior to surgical clipping and showed a slight trend toward better prognosis.
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Racial disparities have been shown to affect surgical outcomes. However, the effect of race on complex spinal fusion outcomes remains understudied. The aim of this study is to determine if patient race affects 30-day complication rates after elective complex spinal fusion (≥5 levels). ⋯ Our study suggests that there is no difference between races in 30-day complication and readmission rates after complex spinal surgery requiring ≥5 levels of fusion.
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Favorable outcome in patients presenting with aneurysmal subarachnoid hemorrhage (SAH) is determined by several factors. Nevertheless, data on the influence of prior use of oral anticoagulation drugs on functional outcome in patients suffering from SAH are scarce. We therefore analyzed our institutional data. ⋯ Anticoagulation therapy has not been identified as a significant and independent factor influencing functional outcome in patients suffering from SAH. Therefore treatment should not be omitted. Nevertheless, cautious management is necessary in patients with known anticoagulation therapy before SAH.
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Case Reports
Trigeminal Ganglioneuroma: A rare cause of trigeminal neuralgia caused by cerebello-pontine angle tumor.
Intracranial ganglioneuromas are very rare benign tumors of neural crest origin and generally arise from the peripheral nervous system or adrenal glands. Very few cases of intracranial ganglioneuroma arising from the trigeminal nerve have been reported in the literature, all in East Asia. ⋯ To the best of our knowledge, this is the sixth case of trigeminal ganglioneuroma; however, it is the first case reported in the United States.
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Cryptococcus spp. is a rare cause of ventriculoperitoneal shunt (VPS) infection, with a variable clinical presentation. Diagnosis and treatment of this entity are challenging. ⋯ This is the first reported case of cryptococcal VPS infection in a patient with human immunodeficiency virus infection. Clinical outcome was excellent after dual antifungal therapy plus device withdrawal. Diagnosis and treatment of this entity remain a challenge for clinicians.