World Neurosurg
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We sought to investigate and report a novel surgical technique of screws insertion and posterior surgical reduction, as well as explore its clinical results. ⋯ This novel surgical technique is safe, feasible, and effective for the treatment of unstable craniovertebral junction anomalies with a narrow C2 pedicle.
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Intracerebral plasmacytoma is an extremely rare disease for which no treatment protocol has been established. The authors present a case of metastatic intracerebral plasmacytoma that was partially resected and treated with radiation therapy. For tumor recurrence, a combination chemotherapy regimen was initiated. ⋯ Hereafter, two more times of tumor recurrence occurred in the other sites of the cerebral parenchyma, but with chemoradiation therapy, the tumor was well suppressed. The findings of this case suggest that the cerebral parenchyma can be one of the metastatic sites for extraosseous plasmacytoma. In addition, combination chemotherapy with thalidomide, dexamethasone, and cyclophosphamide may be a useful treatment option for intracerebral plasmacytoma.
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Case Reports
Postoperative Ptosis and Diplopia Induced by the Intraoperative Application of Bone Wax.
Bone wax is a hemostatic agent well used by neurosurgeons to prevent bleeding from bone. However, several complications involving bone wax have been reported, such as ptosis, infection, paraplegia, osteohypertrophy, edema, pain, granuloma formation, allergic reaction, and thrombosis. ⋯ The authors report a case with complications of ptosis and diplopia after the use of bone wax. Bone wax should be used minimally to the extent possible to avoid an unexpected harmful event.
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Recently, we reported a tendency toward spontaneous hemorrhage in both the preoperative and postoperative periods in patients with intracranial epidermoid cyst (EC). According to our experience, this tendency for spontaneous hemorrhage was partly caused by the pathologic blood vessels adjacent to the EC. This study was designed to testify this hypothesis. ⋯ Our findings provide strong evidence for the hypothesis that intracystic or pericystic vascular degeneration or destruction accounts for the spontaneous hemorrhage tendency before and after surgical resection of ECs.
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To analyze the predictors for and clinical impact of gross total resection (GTR) in patients with glioblastoma (GBM). ⋯ Although a prospective randomized trial on this topic is unlikely to be completed, this large retrospective analysis provides evidence to support the recommendation of GTR in patients with GBM. This study does not support a survival benefit of STR over biopsy alone (when grouped into these 2 groups), although there may be a subset of patients with near total resection who would benefit.