World Neurosurg
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Unruptured intracranial aneurysms (UIAs) have become an issue of greater significance as their detection rates have increased over the years. We present the overall experience of microsurgical clipping of unruptured aneurysms by a single surgeon over a period of more than 16 years. ⋯ Surgical clipping is effective and can provide a good long-term outcome. The most commendable consequence that it provides is a better long-term occlusion rate. The experience of the individual surgeon is important for a superior and enduring overall outcome. An increase in the rate of coiling in recent years has affected the outcome rate after surgery that calls for further evaluation.
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Multicenter Study
Stent-Assisted Coiling May Prevent the Recurrence of Very Small Ruptured Intracranial Aneurysms: A Multicenter Study.
To evaluate the safety and efficacy of endovascular treatments, including stent-assisted coiling, of very small (≤3 mm), ruptured intracranial aneurysms. ⋯ Endovascular treatment of very small ruptured aneurysms was safe and effective and was not associated with a high rate of intraprocedural rupture. Treatment with the use of stents significantly lowered the recurrence rate without additional risks.
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Percutaneous endoscopic lumbar discectomy (PELD) has been widely used for treating lumbar disc herniation. Recurrence after PELD has been reported, but few studies have focused on the risk factors responsible for recurrence after PELD. ⋯ Obesity (body mass index ≥25) was the most robust risk factor responsible for recurrence after PELD. Older age (≥50 years old), learning curve of the surgeon (<200 cases), treatment period (March 2005 to September 2010), and central location of herniation were also closely associated with recurrent herniation after successful PELD.
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Intracranial psammomatous meningiomas (PMs) are rarely reported due to their extremely low incidence. Knowledge about intracranial PMs is therefore poor. This study aimed to analyze the incidence, clinical features, radiologic findings, and surgical outcomes of intracranial PMs. ⋯ Intracranial PM is a rare subtype of meningioma with marked female predominance and low tendency toward growth and recurrence. Most intracranial PMs exhibit highly calcified imaging characteristics, particularly as seen by computed tomography. Microsurgical treatment of skull base PM remains a formidable challenge due to the hard tumor consistency and critical neurovascular structure encasement. It is unnecessary for radical tumor resection at the cost of severe neurologic deficits.
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Comparative Study
Posterior Temporary Fixation Versus Nonoperative Treatment for Anderson-D'Alonzo Type Ⅲ Odontoid Fractures: Functional CT Evaluation of C1-C2 Rotation.
To evaluate differences in radiologic and functional outcomes between C1-C2 posterior temporary fixation (PTF) and cephalocervicothoracic cast fixation for type III odontoid fractures. ⋯ The outcomes of PTF and cephalocervicothoracic cast fixation were comparable in the treatment of type III odontoid fractures. For type III odontoid fractures that cannot be managed by nonoperative fixation or anterior screw fixation, PTF may be the treatment of choice, because it spares the motion of the C1-C2 complex.