World Neurosurg
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This study aimed to evaluate the accuracy of screw placement and clinical outcomes in patients undergoing occipitocervical fusion. ⋯ Occipitocervical fusion with O-arm-based navigation is effective and safe for treating instability of the craniovertebral junction. Intraoperative navigation can help surgeons insert screws accurately.
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Endoscopic surgery for lumbar stenosis is gaining acceptance because of the minimal muscle damage, short recovery times, reduced blood loss, and good clinical results. We report a novel technique of decompressing contralateral traversing and exiting nerve roots through a single interlaminar window, avoiding separate incision for foraminal decompression with minimal damage to facet joints and comparing morphometric changes after decompression. ⋯ Biportal endoscopic decompression of the lateral recess and cranial foramen through a single interlaminar window can be performed using a contralateral approach. In view of the good clinical and radiologic outcomes of patients, with notable improvements in morphometric measurements at stenosed segments, this surgical technique is worthy of further evaluation and application.
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Case Reports
Unusual Clinical Sequelae of Kawasaki Disease-Symptomatic Extracranial Internal Carotid Stenosis in Young Adult.
Kawasaki disease (KD) is an acute systemic vasculitis that primarily affects the coronary artery, but it does not commonly affect the carotid artery. Cerebral infarction (CI) with internal carotid artery stenosis (ICS) in patients with KD has not been reported until now. We report a patient with CI as a remote-phase complication of KD. ⋯ KD in childhood may cause symptomatic ICS as a sequela of a remote phase.
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Case Reports
Dural Arteriovenous Fistula Between the Inferolateral Trunk and Cavernous Sinus Draining to Ophthalmic Vein.
Formation of a dural arteriovenous fistula (DAVF) between the inferolateral trunk (ILT) and cavernous sinus (CS) is rare. ⋯ Although ILT-CS DAVF is rare, it can still be seen in clinical practice. Coiling the ILT via a transarterial approach is a good option for treatment.
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Case Reports
Craniotomy for a Large and Aggressive De Novo Cavernous Malformation Resection in the Basal Ganglia Region.
Cerebral cavernous malformations (CCMs) are present in up to 0.5% of the general population. Although CCMs have been considered congenital lesions, numerous reports have observed de novo formations in patients with the familial form of CCM and in patients after cranial radiotherapy. Outside of these circumstances, there is scant evidence as to the potential etiologies of CCM. ⋯ Given the patient's medical history and imaging findings, we propose that de novo CCMs can arise directly from angiogenic proliferation, secondary to BCL-2 overexpression from underlying causes. We hypothesize that inappropriate secretion of estrogen could have set off a genetic cascade with attendant endothelial proliferation. Thus, female hormones may play an important role in influencing the biological behavior of CCMs. The relationship between estrogen and CCM needs further investigation.