World Neurosurg
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To investigate if the implementation of white matter (WM) fiber tractography by diffusion tensor imaging in presurgical planning for supratentorial tumors proximal to eloquent WM tracts can alter a neurosurgeon's operative strategy. ⋯ DTI WM tractography helped neurosurgeons to correctly identify patients with interrupted motor and optic pathway tracts so they could be more aggressive with the extent of tumor resection, despite its inability to alter the operative approach.
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Computed tomography images of patients with chronic subdural hematoma (CSDH) sometimes show obliteration of the basal cistern with high density in an obliterated Sylvian cistern, termed pseudo-subarachnoid hemorrhage (SAH). The present study aimed to clarify the characteristics and outcomes of these conditions. ⋯ Although the outcomes of patients with basal cistern effacement and pseudo-SAH were similar to outcomes of other patients with CSDH, problematic postsurgical complications and cerebrospinal fluid leaks were more likely to arise in such patients.
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Case Reports
Complete transection of optic nerve after endovascular coiling of a large ophthalmic artery aneurysm: Case report.
We describe a patient who developed delayed blindness of the left eye at 5 weeks after endovascular coiling of a large ophthalmic aneurysm. ⋯ This report describes a rare complication of a sudden increase in size of a large ophthalmic aneurysm despite successful endovascular occlusion.
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Intraosseous petrous apex schwannomas are an exceedingly rare entity; little is known about their epidemiology, natural history, and postoperative outcomes. ⋯ Our 2-year follow-up demonstrates slow growth and success of multimodal management in the treatment of these tumors. We review the 3 prior reports of petrous apex schwannomas and identify unifying radiographic and clinical characteristics to aid future diagnostic considerations of lesions of the petrous apex.
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Intracranial epidermoid cysts are developmental central nervous system abnormalities that arise from erroneous ectodermal inclusion during neural tube closure. Epidermoids are relatively common, representing 1% of all intracranial masses, and are particularly predominant in the cerebellopontine angle (CPA), where they are the third most prevalent diagnosis after schwannomas and meningiomas. ⋯ By use of a 2-surgeon 4-hands technique, the mass was dissected from the surrounding neurovascular structures, and a gross total removal was achieved with no postoperative neurologic deficits. Our video highlights the critical nuances pertinent to the fully endoscopic resection technique, with special attention to the relative restrictions of a small working corridor parallel to the tentorium and the petrous bone.