World Neurosurg
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To compare and analyze the differences in clinical manifestations and surgical outcomes after gross total resection (GTR) for vestibular schwannoma between elderly and younger patients. ⋯ Elderly patients tended to suffer from poorer health (American Society of Anesthesiology score) and poor balance before the operation; however, they did not experience more complications, worse nerve function, or worse quality of life in the perioperative or follow-up times. We conclude that GTR of vestibular schwannomas, even large or giant ones, is a safe and effective option for elderly patients.
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Case Reports
Endovascular Treatment of Intracavernous Internal Carotid Aneurysm Secondary to Pituitary Infection: A Case Report.
Intracavernous internal carotid artery (ICICA) aneurysm secondary to pituitary infection is exceedingly rare. ⋯ This rare case highlights a life-threatening complication of a pituitary infection. Moreover, enlargement of the infected ICICA aneurysm could not be relieved by conservative anti-infective therapy. Endovascular treatment may be an alternative therapy for an infected ICICA aneurysm.
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Moyamoya disease (MMD) is a cerebrovascular disease characterized by progressive stenosis of the intracranial internal carotid arteries and their proximal branches. Epidemiologically, MMD is more prevalent in East Asia than any other region worldwide, and has been estimated at 0.94 per 100,000 in the Japanese and 0.43 per 100,000 in the Chinese population. The etiology of this rare disease, however, remains unknown. ⋯ Recent genome-wide and locus-specific association studies identified RNF213 as an important susceptibility gene of MMD among the East Asian population. The exact mechanism by which the RNF213 abnormality relates to MMD remains unknown, whereas recently identified RNF213 encodes a 591-kDa protein containing enzymatically active P-loop ATPase and ubiquitin ligase domains and is involved in proper vascular development in zebrafish provide new insight for the pathogenesis of this rare entity. In this review article, we focused on the genetics and biomarkers of MMD and sought to discuss their clinical implication.
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Watertight reconstruction to separate the intradural compartment from the sinonasal cavities is crucial after endoscopic resection with transnasal craniectomy for nasoethmoidal tumors. A 3-layer reconstruction with the iliotibial tract is a safe and reliable alternative when vascularized flaps are unavailable. ⋯ Use of fibrin glue and intradural irrigation may help the surgeon to stabilize the layers during reconstruction. Three-layer reconstruction with the iliotibial tract is a feasible, highly reproducible, safe, and always available option for reconstruction of anterior skull base defects after endoscopic resection with transnasal craniectomy for nasoethmoidal tumors.