World Neurosurg
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Neurosurgeons who operate in and around the pathway of the ocular nerves should have good knowledge of not only their normal anatomy but also their variations. ⋯ Surgeons who operate along the pathway of the trochlear nerve such as the cavernous sinus should be aware of such an anatomic variant in order to avoid unwanted complications such as weakness of the orbicularis oculi muscle.
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Therapeutic strategies for managing hemorrhagic moyamoya disease (MMD) remain controversial. In this study, we investigated the optimal therapy for hemorrhagic MMD. ⋯ Surgical revascularization, especially a direct bypass regimen, may be the optimal strategy for treating hemorrhagic MMD.
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Review Case Reports
Sciatica Caused by Venous Varix Compression of the Sciatic Nerve.
The authors report the case of a 76-year-old woman presenting with leg pain, numbness, and weakness mimicking a lumbosacral radiculopathy. ⋯ Variceal compression is a rare cause of extraspinal origin of lower extremity radicular pain. It should be considered if there is lack of correlation between radiologic findings and the clinical picture or if there is a failure of response to treatment of the assumed spinal cause.
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This study aimed to summarize the diagnosis, therapy, and prognosis of pituitary metastasis. ⋯ Pituitary metastasis is a rare disease. Its diagnosis depends on the clinical manifestations and radiologic results. The primary therapeutic method is surgery and subsequent radiotherapy and chemotherapy; however, the prognosis of this disease is poor.
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Chronic subdural hematoma (CSDH) often occurs in association with cerebrospinal fluid (CSF) hypovolemia. Many cases with CSDH due to CSF hypovolemia and treated by burr hole surgery have been reported to present with paradoxical deterioration. However, the mechanisms and pathology of deterioration after surgery for CSDH due to CSF hypovolemia remain obscure. ⋯ SDFC deteriorating after surgery has never been reported. SDFC has communication with CSF differing from mature CSDH composed of closed cavity surrounded by neomembrane. Under situations of CSF hypovolemia due to spinal dural tear, opening the cranium can prompt air replacement in the CSF space, which might represent a substantial risk for central herniation caused by a rapid loss of buoyancy force.