World Neurosurg
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The management issues of 15 cases of giant and dumbbell-shaped facial neurinomas that extended both in the middle and posterior cranial fossa are reported. ⋯ Understanding the fact that the facial nerve neurinomas are interdural in nature and soft and necrotic in character can allow quick and safe surgery with a relatively small surgical exposure.
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Management of encephaloceles is challenging when massive brain herniation is present. In such instances, an expansile cranioplasty may be attempted so as to preserve some herniated brain tissue. Complications such as wound dehiscence, cerebrospinal fluid leak, and scalp necrosis are postoperative concerns. The treatment of scalp necrosis with dural and brain exposure is certainly a challenge due to the complexity of flap techniques in such a young age. Herein we describe the use of a novel technique for the management of a scalp necrosis and dehiscence in an infant. ⋯ A simple technique, such as the use of an artificial dermal matrix with simultaneous split-thickness skin graft, may be an effective treatment for the repair of scalp defects, even when coverage of exposed brain tissue is necessary, when no other techniques are found to be suitable.
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Treatment of intracranial aneurysms (IAs) is largely guided by IA size and growth. Preliminary investigations have found a relationship between clinical factors and growth; yet, the relationship between morphologic and hemodynamic risk prediction models in IA growth is unknown. ⋯ Based on this preliminary study, we conjecture that aneurysms that resemble ruptured IAs may grow faster.