World Neurosurg
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The present study is focused on correlation of parent vessels and neck diameters with anterior communicating artery (AComA) aneurysmal depth and growth direction. The study principally aims to suggest a new classification of AComA-located aneurysms based on the physical characteristics of parent vessels. ⋯ The dominant A1 bifurcation type is the most common type of AComA-located aneurysm. The present classification provides clinical value in understanding how AComA aneurysms grow and behave. It helps to understand the geometry of multilobulated aneurysms such as ruptured blebs locations during treatment procedures respecting the direction of the dominant A1 axis in group II. Multiple anatomic variations of this complex AComA area can clarify future subtypes of these 2 groups. Thus, further investigation of more patients is needed.
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Glioblastomas are highly aggressive and heterogeneous tumors, both in terms of patient outcome and molecular profile. Magnetic resonance imaging of tumor growth could potentially reveal new insights about tumor biology noninvasively. The aim of this exploratory retrospective study was to investigate the prognostic potential of pretreatment growth rate of glioblastomas, after controlling for known prognostic factors. ⋯ Pretreatment glioblastoma growth harbors prognostic information. Patients with slower growing tumors have higher odds of survival beyond 2 years, adjusted for other prognostic factors.
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The objectives of this study were to analyze microsurgical techniques and to determine correlations between microsurgical techniques and the radiographic findings in the microneurosurgical treatment of posterior communicating artery aneurysms (PCoAAs). ⋯ For ruptured aneurysms, lamina terminalis and Liliequist membrane fenestration are useful for additional cerebrospinal fluid drainage. For low-lying aneurysms, coagulation of the dura covering the ACP or tailored anterior clinoidectomy might be necessary for exposing the proximal aneurysm neck. Type of clips depends on the direction of projection. The microsurgical clipping of the PCoAAs can achieve good immediate complete occlusion rate with low postoperative stroke rate.
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Os odontoideum is an uncommon abnormality of the craniovertebral junction where the tip of the odontoid process lacks continuity with the body of C2. The clinical presentation is variable, but severe neurologic impairment can result. ⋯ To our knowledge, there are no cadaveric reports in the literature regarding an os odontoideum. Such a case allows a rare window into the anatomy and relationships of this pathologic structure.
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Familial cases of idiopathic intracranial hypertension (IIH) are exceedingly rare, and its occurrence in monozygotic twins has not been reported previously. ⋯ This report documents the first case of IIH in monozygotic twins and the associated changes in ICP dynamics. Interestingly, almost equivalent alterations in ICP dynamics were found in the 2 patients.