World Neurosurg
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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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Microvascular decompression (MVD) has become widely accepted as first-line therapy for hemifacial spasm. However, not all patients are candidates for the procedure, and some surgeons ignore arterioles that represent the actual underlying cause of the condition. The aim of this study was to address the role of involved arterioles in management of MVD in patients with hemifacial spasm. ⋯ The main reason for failed MVD is that the involved offending vessel is not correctly identified. Intraoperative abnormal muscle response and Z-L response are good supplementary measures to identify involved arterioles. In addition, not isolating or coagulating the involved arterioles increases the risk associated with the operation.
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Case Reports
Neonatal Intracranial Pial Arteriovenous Fistula Treated with Endovascular Embolization: A Case Report.
Pial arteriovenous fistulas (PAVFs) are rare vascular malformations, especially in neonates. The purpose of this report is to discuss the treatment strategy and its associated challenges. We present a case of prenatal intracranial PAVF treated by endovascular embolization in the neonatal period. ⋯ Despite current developments in medical technology and therapies, the effective treatment of critical PAVFs still poses a challenge. Therefore, more indications and effective alternative treatments must be discussed.
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Case Reports
Filum Terminale Arteriovenous Fistulas with Multiple Shunt Points: A Report of Two Exceptional Cases.
Filum terminale arteriovenous fistula (FTAVF) with multiple shunt points has not been reported in the literature. In previous studies, the angioarchitecture of FTAVFs was always featured with only one single shunt point, and such a uniformity had established the preconceived and conventional understanding of FTAVFs for clinicians. ⋯ The exceptional finding of these 2 cases is a renewal of the conventional understanding of FTAVFs, not only for the angioarchitecture of the lesions but also for the treatment strategy.
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Difficulties are associated with the diagnosis and management of patients with coma because of intracranial hypotension. ⋯ The patient represents the first described case, to our knowledge, of intracranial hypotension with coma because of a CSF leak caused by a spinal ventral dural tear. In the setting of failed EBP attempt, our technique may be a treatment option for severe intracranial hypotension.