World Neurosurg
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Craniovertebral junction (CVJ) meningiomas are one of the most surgically complex conditions in neuro-oncologic surgery. The aim of this work is to correlate our data with clinical outcome to outline factors leading to a worse functional prognosis. ⋯ We selected, in our experience, some predictors of worse outcome: preoperative sphincter impairment, absence of a capsule, cranial site of origin, a poor preoperative functional status, and firm consistency of the tumor.
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To report the outcome of patients with very small intracranial aneurysm (VSIA) undergoing surgical clipping using a double-clip technique. ⋯ VSIAs are difficult to treat because of their small sizes; therefore, with a double-clip technique, one can reduce complications related to the treatment of small aneurysms.
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The aging population in industrialized countries shifts the age limit for neurosurgical interventions toward increasingly older patients. This study investigates whether octogenarians (≥80 years) stand out in outcome and incidence of perioperative complications. ⋯ Neurosurgery in octogenarians had a similar rate of severe complications, morbidity, and mortality as in matched controls. Therefore, age alone should not serve as a contraindication for neurosurgery.
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Although isolated transverse process fractures (ITPF) do not confer any inherent risk of compromised spinal stability, there is increasing interest in their overall prognostic significance. As a proxy for localized or directional forces in high-energy traumatic mechanisms, ITPF may serve as an indicator for the presence of other coexisting traumatic injuries. Specific injuries may be predicted by the presence of ITPF at specific spinal levels, but few studies have examined this in depth and may not account for confounding variables. ⋯ Spinal level of ITPF is associated with increased likelihood of specific patterns of injury, and additional investigation is warranted.
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To evaluate role of surgery plus radiotherapy (RT) in patients with metastatic epidural spinal cord compression from breast cancer with a follow-up >10 years. ⋯ Surgery plus RT is a safe and feasible treatment with limited morbidity. In selected patients with good performance status, positive hormonal receptors, and limited metastatic disease, surgical intervention should be strongly considered early on.