World Neurosurg
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The apical ligament has long been reported to contain notochord remnants and thus might serve as a site of origin of chordoma formation at the skull base. However, to our knowledge, the histologic study of the apical ligament using histologic staining specific for notochordal tissue has not been previously performed. Therefore the current study was undertaken. ⋯ On the basis of our cadaveric study, the apical ligament does not contain notochord tissue and in adults should not be considered a remnant of this structure. Moreover, it is unlikely that the apical ligament gives rise to chordomas at the craniocervical junction under normal circumstances.
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The purposes of this study were to evaluate the feasibility of a purely endoscopic intradural approach to the suprasellar, petroclival, and ventrolateral brainstem regions through a subtemporal keyhole and to assess the value of neuronavigational assistance in the Kawase approach. ⋯ The endoscopic intradural subtemporal keyhole approach could facilitate excellent observation of the suprasellar, petroclival, and ventrolateral brainstem regions with less invasiveness. More anatomic exposure and surgical freedom could be achieved via neuronavigational assistance with fewer complications.
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There is no definite operative procedure for patients with intractable chronic subdural hematoma (CSDH). We describe the safety and efficacy of embolization treatment of the middle meningeal artery (MMA) for such cases. ⋯ This pilot study indicated that perioperative MMA embolization could be offered as the least invasive and most effectual means of treatment for resistant patients of CSDHs with 1 or more recurrences.
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Case Reports
Trigeminal Neuralgia Completely Relieved after Stent Assisted Coiling of a Superior Cerebellar Artery Aneurysm.
Although secondary trigeminal neuralgia is usually due to tumors or multiple sclerosis, other major neurologic diseases, such as aneurysms, should be taken into account when the history or the symptoms suggest a secondary origin. ⋯ The complete relief from the neuralgic paroxysms immediately after endovascular stent-assisted occlusion of a superior cerebellar artery aneurysm demonstrates the crucial role of a pulsating stimulus on the demyelinated nerve fibers in evoking the ectopically generated discharges.
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Subependymomas are rare, slow-growing, benign tumors. Because they are scarce, knowledge relating to survival remains lacking. Consequently, we explore the SEER database to evaluate prognostic and treatment factors associated with intracranial subependymoma. ⋯ Clinical factors such as younger age, female sex, and location within ventricles or near brain stem demonstrated positive relationship with overall survival. For treatment options, surgery remains a mainstay option. No support for radiation therapy was identified.