World Neurosurg
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To analyze the preservation of hypothalamic function using the endoscopic endonasal approach (EEA) in a single-center clinical series of patients with hypothalamus-invaded craniopharyngioma (CP) and compare this series with reported cases by the open transcranial approach (TCA). ⋯ EEA can achieve greater gross total resection than TCA when performed by an experienced surgeon. Combined with the reduced postoperative hypothalamic damage in our patients with only hypothalamus-invaded CP, especially the shortened time horizons of hypothalamic obesity development and reduced percentage of patients with obesity, the EEA technique should be a preferred alternative over TCA.
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This study aims to evaluate the safety and effects of using argatroban, immediately after mechanical thrombectomy (MT) with large artery occlusion. ⋯ This study showed the safety and usefulness of argatroban immediately after MT, indicating that using argatroban after MT could prevent reocclusion of target artery without increasing bleeding complications.
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The use of the recent concept of sellar barrier revealed that a specific group of patients were difficult to categorize. For this reason, we propose to add a new subtype: the mixed sellar barrier. The aim of this work was to define the new mixed barrier subtype and analyze this in a series of operated patients. ⋯ The new mixed sellar barrier subtype was precisely defined and illustrated. The correlation between MRI and intraoperative findings for this new subtype has been demonstrated in this study. A prospective study with a larger series of patients is required for validation.
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To search for texture features of routine magnetic resonance imaging to predict tumor volume reduction and transient versus permanent tumor progression of vestibular schwannomas treated by Gamma Knife stereotactic radiosurgery. ⋯ Texture feature analysis helps to predict permanent versus transient enlargement and final volume reduction of schwannomas after SRS. Thus, alternative treatment strategies might be considered, mainly in large tumors, where further clinical deterioration cannot be excluded. To confirm these results, a prospective study including more cases and a longer follow-up period is necessary.
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Management of pediatric skull defects after decompressive craniectomy (DC) poses unique problems, particularly in children younger than 24 months. These problems include complications such as resorption and infection as well as difficulties with plagiocephaly and reconstruction. The goal of this study was to evaluate bone resorption complications after cranioplasty in patients <24 months. ⋯ In patients younger than 24 months undergoing cranioplasty subdural collection, a lack of shunt placement and increased time to cranioplasty were associated with increased rates of resorption.