World Neurosurg
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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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The endoscopic endonasal approach has recently become an acceptable option for resection of all pituitary adenomas. We assessed biochemical outcome of endoscopic endonasal surgery in growth hormone (GH)-secreting adenomas, including remission rate, predictors of remission, and associated complications. ⋯ Endoscopic endonasal adenoma resection leads to a high rate of endocrinologic remission in GH-secreting adenomas with a low complication rate. Patients with older age, higher preoperative GH levels, and higher Knosp grades are less likely to achieve remission.
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Case Reports
Flow Diversion via LVIS Blue Stent within Enterprise Stent in Patients with Vertebral Artery Dissecting Aneurysm.
A new Low-profile Visualized Intraluminal Support device (LVIS Blue) is a braided stent that provides a higher degree of metal coverage. This stent may be beneficial for complete obliteration of an aneurysm due to not only its support of a higher occlusion rate using coils inside of the aneurysm but also its flow-diverting effect. We introduce and describe a new flow-diversion technique using an LVIS Blue stent within an Enterprise stent for patients with vertebral artery (VA) dissecting aneurysms. ⋯ An LVIS Blue stent was introduced and positioned such that it overlapped the previous stent in order to divert blood flow away from the dissecting segment. We present a case in which this technique was used to successfully obliterate a dissecting aneurysm while maintaining the VA patency with vessel wall remodeling. The LVIS Blue stent-within-an-Enterprise stent technique may be an effective treatment option for patients with VA dissecting aneurysms as an alternative technique to flow diverters.
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To date, no information about the cortical bone microstructural properties in atlas vertebrae with arcuate foramen has been reported. As a result, we aimed to test in an experimental model if there is a cortical bone thickening in an atlas vertebra which has an arcuate foramen that may play a protective role against bone fracture. ⋯ An atlas with arcuate foramen presents cortical bone thickening. This advantage in bone microarchitecture seems to contribute to a lower fracture risk compared to subjects without arcuate foramen as no coexistence in the same vertebra of a posterior atlas arch fractures and arcuate foramen was found.
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Craniovertebral junction diseases, although considered rare, are common in northern parts of India. This study was conducted to evaluate the clinico-radiologic and surgical outcome of patients with a minimum follow-up of 1 year. Our study also compared bony fusion among various techniques of posterior fusion. ⋯ The key to successful management of craniovertebral junction disease is individualized selection of judicious surgical intervention from various available techniques.