World Neurosurg
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Advanced magnetic resonance imaging (MRI) acquisition methods such as 4D phase contrast magnetic resonance imaging (4D pcMRI) have found widespread applications in assessing hemodynamics in cerebral aneurysms. One of the goals is the identification of a hemodynamic scenario predictive of aneurysm rupture. Because of the technical complexity the 4D pcMRI technology, challenges exist in extracting and communicating the wealth of information contained in the MRI image data, in particular, to a multidisciplinary team of health professionals and basic scientists. ⋯ Augmented reality may become an additional means for visualizing complex medical data, in particular complex flows as illustrated here.
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This study aimed to clarify the relationship between histone deacetylase 3 (HDAC3) expression and the prognosis as well as the grade of patients with glioma. ⋯ HDAC3 mRNA was expressed more in glioma than in the normal glial cell line. Low HDAC3 mRNA expression levels predicted better OS. HDAC3 expression could be a biomarker to discriminate glioma grade.
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Awake surgery is an effective technique to improve safety in surgical resection of lesions involving eloquent areas of the brain. Intraoperative imaging guidance and neuronavigation are widely applied in neurosurgical procedures. However, data on the application of intraoperative imaging to awake craniotomies are limited. We report our experience with intraoperative computed tomography (i-CT) during awake surgery, focusing on technical feasibility and effectiveness. ⋯ i-CT in awake surgery is reliable and effective. It does not significantly affect the duration of surgery and does not add stress for the patient. The possibility to correct for brain shift also in awake patients can increase the precision and accuracy of surgery, particularly in cases of LGG, avoiding the resection of normal white matter or tumor remnants in noneloquent areas.
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Hemiparesis is a major symptom of chronic subdural hematoma (CSDH). Its severity does not always correlate with hematoma size. The authors analyzed hematoma thickness, pressure, and tension to clarify the mechanism of hemiparesis in CSDH patients. ⋯ Tension is the most influencing factor to hemiparesis in CSDH patients. This study also elucidates the mechanism for quick recovery from hemiparesis after surgery in that tension on the motor cortex is decreased immediately by drainage.
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To explore whether computed morphologic features can be used as independent predictors of incomplete occlusion of aneurysms treated with the Pipeline embolization device. ⋯ Malapposition of stent and higher elongation value were independent negative predictors of aneurysm occlusion following flow diversion.