World Neurosurg
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Hypoglossal nerve injury may result in swallowing and speech problems. To reduce this morbidity and allow the performance of the hypoglossal-facial nerve anastomosis bilaterally, a technique that includes partial splitting of the hypoglossal nerve and skeletonization of the facial nerve within the mastoid process has been applied. The aim of this study is to present clinical results regarding the facial and hypoglossal nerves after the procedure. ⋯ HHFA is an effective technique for facial nerve reanimation with acceptable morbidity related to tongue function. Patients with a longer duration of facial palsy still have a good chance for restoration of facial movement but require longer recovery periods.
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To investigate prognostic factors of clival chordoma using the largest patient set to date. ⋯ GTR rates were comparable in different surgical approaches. GTR was a significant predictor of longer PFS and OS in clival chordoma.
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We report a case of a ruptured fusiform aneurysm of the distal internal carotid artery (ICA) involving the anterior choroidal artery and posterior communicating artery, treated with selective coil embolization. ⋯ Mostly, surgical clipping (vascular reconstruction, proximal occlusion, or trapping) with bypass surgery is necessary for this lesion. However, in our case, selective coiling was successfully performed only at the suspected rupture point. This technique can be a good alternative treatment modality.
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To evaluate safety and efficacy of pedicle screw with polymethyl methacrylate (PMMA) augmentation in unilateral transforaminal lumbar interbody fusion (uTLIF) in osteoporotic patients. ⋯ Pedicle screw with PMMA augmentation can increase fixation stability and reduce DSH loss in uTLIF. Moreover, PMMA in the vertebral body did not impede the interbody fusion ability in uTLIF.
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Fungal mass lesions in the central nervous system are, as a group, extremely rare. In this group cryptococcomas are the most common mass lesions seen. These cryptococcomas/mucinous pseudocysts are commonly only 3-10 mm in diameter and occur almost exclusively in the basal ganglia through contiguous spread from a basal meningitis through the Virchow-Robbin perivascular spaces. In rare cases a chronic granulomatous process may lead to formation of mass lesions that have a tumoral appearance. ⋯ Diagnosing the tumoral form of cryptococcosis in immunocompetent patients is a challenge. Primary and secondary brain tumors are usually the first hypotheses in these cases. Thorough preoperative investigation through cerebrospinal fluid sampling and detailed magnetic resonance imaging may lead to consideration of this diagnosis before the histopathologic analysis has been conducted.