World Neurosurg
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The volume of activated tissue (VTA) model attempts to represent in 3 dimensions the diffusion of the current provided by the deep brain stimulation lead on brain structures. The objective of the present study was to assess the correlations among the VTA, activation of the corticospinal tract, and the intraoperative side effect (ISE) threshold. ⋯ The present study is the first to show a relationship between the intensity threshold as determined by the use of the VTA and the ISE threshold. The correlation between the clinical features and the VTA appears to be stronger in the model based on a combination of high-resolution anatomic data and interpretable DTI data.
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Although the ipsilateral inferior petrosal sinus (IPS) is preferred for treatment of cavernous sinus dural arteriovenous fistulas (CS-dAVFs), this method is problematic if ipsilateral IPS is occluded. We describe our experience in treating CS-dAVFs with ipsilateral IPS occlusion via the ascending pharyngeal artery (APA). ⋯ CS-dAVF with ipsilateral IPS occlusion can be treated via various methods. Embolization through the APA as an initial access is a reasonable choice.
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Laser interstitial thermal therapy (LITT) enables ablation of lesions using thermal energy with minimal damage to surrounding regions. Bevacizumab has been used as an adjuvant therapy in recurrent glioblastoma (GBM). At present, bevacizumab is administered at least 4-6 weeks after surgical intervention; however, given the minimally invasive nature of LITT, we suggest that bevacizumab can be safely administered at a shorter interval after LITT. ⋯ This case series suggests that bevacizumab administration is safe within 1 month after LITT, thus showing promise in treating recurrent GBM. Larger studies are warranted to assess the efficacy of combined bevacizumab and LITT.
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Regardless of acceptable surgical results of middle cerebral artery aneurysms (MCAs), MCA territory infarction (MCATI) remains a major obstacle to achieving a good outcome. We investigated the MCATI in patients with surgically treated MCA aneurysms. ⋯ In the present study, compared with M1-2 aneurysms, MCATIs were observed more frequently in EFCB aneurysms, and the presence of MCATI and a larger size ratio were related to 12-month neurologic worsening in patients with surgically treated MCA aneurysms.
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Carotid Doppler sonography has been used routinely in the screening for restenosis after carotid artery stenting (CAS) by applying the criteria of flow velocity; however, computed tomography angiography (CTA) enables us to detect restenosis directly and has some advantages that help to overcome the limitations of Carotid Doppler sonography. We aimed to investigate the incidence of restenosis with CTA and to identify factors related to restenosis after CAS. ⋯ This study revealed that carotid arteries with high-grade calcification were prone to develop restenosis after CAS. Regular follow-up should be performed for the monitoring of restenosis after CAS in patients with highly calcified carotid plaques.