World Neurosurg
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Comparative Study
Direct Comparison of Gamma Knife Radiosurgery and Microsurgery for Small Size Meningiomas.
Patients with small (<3 cm) intracranial meningiomas can be either observed or treated. Treatment can be either radiosurgery or microsurgery if and when tumor progression occurs. We compared local tumor growth control and recurrence-free survival (RFS) of microsurgical resection and radiosurgery in small intracranial meningiomas and identified predictors of unfavorable outcome. ⋯ GKRS offers a high rate of tumor control and longer RFS that is comparable to Simpson grade I resection. Subtotal resection is not a good choice for small meningiomas. The treatment procedure should be tailored according to the presence of comorbidities and the maximum benefit for the patient.
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Spontaneous intracranial hypotension syndrome results from spontaneous spinal cerebrospinal fluid (CSF) leaks. The first treatment of choice consists of lumbar epidural blood patching. If this fails, further imaging is mandatory to explore the possibility of targeted therapy. ⋯ A targeted epidural blood patch using an epidural catheter represents an elegant approach to a CSF leak at the C1-C2 region and can be successful in treating patients with severe intracranial hypotension syndrome.
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Case Reports
A distinctive pathological meningioma completely without enhancement and dural tail sign on imaging findings.
It is known that meningiomas are common intracranial benign tumors that can be enhanced significantly on computed tomography or magnetic resonance imaging scans after the administration of contrast medium. The authors report here on an extremely rare case of meningioma with distinctive pathological features presenting completely without enhancement and dural tail sign on neuroimaging examination. ⋯ This report illustrates common meningiomas possess the rare occurrence of uncommon neuroimaging characteristics and pathologic features. According to radiologic and pathologic features, the causes of rare imaging characteristics are discussed.
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The Helsinki computed tomography (CT) scoring system was developed to predict long-term outcome in patients with traumatic brain injury (TBI) 2 years ago; however, it has not yet been external validated. This study aimed to determine whether this system could be used as an independent predictor for TBI. ⋯ The Helsinki CT score showed good prognostic discrimination and can be used as an independent predictor for long-term outcome prediction in patients with TBI.
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The role of subaxial and atlantoaxial instability in the pathogenesis of "degeneration"-related cervical kyphosis is evaluated. ⋯ Spinal instability plays a major role in the generation of cervical spinal kyphosis. Atlantoaxial instability may form the primary and nodal site of development of the process of spinal degeneration in general and kyphosis in particular.