World Neurosurg
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We investigated the efficacy of a combined approach with stent retriever-assisted aspiration catheter for distal intracranial vessel occlusion (distal combined technique [DCT]). ⋯ This retrospective analysis indicated that the DCT is a useful and safe strategy for patients with distal anterior intracranial vessel occlusion.
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During endovascular treatment of complex intracranial dural arteriovenous fistulas (DAVFs) of the transverse sigmoid sinus, it can be difficult to preserve the patency of the dural sinus. We have described the details of the transvenous balloon-assisted technique using Copernic RC balloon as a treatment option for patients with complex DAVFs of the transverse sigmoid sinus. ⋯ Transvenous Copernic RC balloon-assisted embolization of DAVFs in the transverse and sigmoid sinuses is safe and can offer complete occlusion of DAVFs and remission of clinical symptoms.
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Atlantoaxial subluxation caused by Brucella infection is rarely seen in children. ⋯ Atlantoaxial dislocation and instability develops secondarily to paravertebral abscesses, only rarely. Like brucellosis of childhood, granulomatous infectious diseases rarely cause atlantoaxial subluxation or dislocation. Torticollis and neck pains should be taken seriously for the purpose of early diagnosis of patients at risk in endemic regions. Stabilization and fusion should be performed when instability is detected, and these patients should be assessed with both pediatric infectious diseases and neurosurgery clinics. Our case is the first one in the literature in which atlantoaxial instability developed due to Brucella infection and stabilization was performed.
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Some patients with hydrocephalus and idiopathic intracranial hypertension treated for elevated intracranial pressure (ICP) with a cerebrospinal fluid shunt may continue to experience symptoms or develop new symptoms despite valve adjustments. Use of telemetric ICP measurements may help confirm clinical suspicion of cerebrospinal fluid underdrainage or overdrainage in these patients. However, point in time, duration, and activity during the measurements have never been standardized. We devised a simple, repeatable maneuver for outpatient telemetric ICP recording and evaluated its test-retest reliability. ⋯ We confirmed high test-retest reliability of the standing-supine-sitting paradigm for telemetric ICP measurements in the outpatient setting. High test-retest reliability should be considered as prerequisite for clinical decision making.
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Case Reports
Dysembryoplastic Neuroepithelial Tumor with an Enlarging Heterogeneously Enhancing Organizing Hematoma.
This report portrays an unusual presentation of a dysembryoplastic neuroepithelial tumor characterized by a chronic, enlarging, heterogeneously enhancing organizing hematoma. Differential diagnoses included the malignant transformation of a low-grade glioma, radiation necrosis, and radiation-induced cavernoma. A dysembryoplastic neuroepithelial tumor may have atypical characteristics and behavior, so continued follow-up with serial imaging is recommended.