World Neurosurg
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Middle cerebral artery (MCA) aneurysms have continued to be primarily managed microsurgically. In cases of complex MCA aneurysms, revascularization could facilitate effective aneurysm treatment. The MCA candelabra provides excellent candidates for in situ side-to-side bypass. In the present case series, we have described applications of MCA in situ side-to-side bypass for the management of complex MCA aneurysms, along with a review of the pertinent data. ⋯ Our experience with MCA side-to-side in situ bypass has demonstrated its safety and utility in complex MCA aneurysm management. The favorable anatomy of the MCA branches allows for minimally invasive revascularization and clipping that can potentially reduce the hospitalization time and incidence of perioperative morbidity.
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Case Reports
Solitary Extra-axial Intracranial Primary Meningeal Pleomorphic Xanthoastrocytoma: An Extremely Rare Case.
Pleomorphic xanthoastrocytomas (PXAs) are a rare type of astrocytoma, which, similar to other gliomas, can rarely arise from glial nests in the meninges, manifesting as an extra-axial mass. We describe a solitary extra-axial intracranial primary meningeal PXA in the pediatric age group, which was masquerading as a tentorial meningioma. ⋯ Solitary extra-axial intracranial primary meningeal PXA is an extremely rare entity with only 3 reported cases in the literature including the present case. This is the first report of such a tumor in a pediatric patient. This report also highlights that primary meningeal PXA can manifest as an extra-axial mass lesion and may warrant inclusion in the differential diagnosis of extra-axial mass lesions.
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Solitary fibrous tumor/hemangiopericytoma (SFT/HPC) and meningioma exhibit similar radiographic features; however, they differ in their prognoses. Preoperative differentiation between them is important for determining the treatment and follow-up plan. The aim of this study was to determine the factors that can be used to differentiate SFT/HPC from meningioma and World Health Organization (WHO) grade I from grade II meningioma. ⋯ Age and myo-inositol level calculated from MRS are useful factors for distinguishing SFT/HPC from meningioma preoperatively.