World Neurosurg
-
The role of adjuvant radiotherapy (ART) in patients with World Health Organization Grade II atypical meningiomas (AMs) remains controversial. ⋯ Patients who undergo STR for newly diagnosed AM should receive ART based on improvements in LC and PFS. GTR patients should be considered for ART, but active surveillance is a reasonable management approach with the recognition that progressive/recurrent disease can act aggressively. Prospective, randomized trials are currently underway to evaluate the role of ART.
-
Protecting the venous drainage route during surgery in cases of petroclival meningioma (PCM) is important. Identifying venous congestion preoperatively can be valuable in reducing the risks associated with venous congestion during surgery. In this study, we examined the utility of susceptibility-weighted imaging (SWI) in identifying the presence of venous congestion in PCM cases preoperatively and identified the factors associated with it. ⋯ We showed that SWI is useful for evaluating venous congestion in PCM cases preoperatively and for identifying factors reflecting the risk of venous congestion. Taken together, our findings provide a multimodal strategy for the preoperative prediction of venous congestion, which could facilitate the treatment of PCM.
-
A 24-year-old woman presented to neurosurgical consultation for chronic back pain. The patient was long term in wheelchair for vertebral deformity. She was the third child of first-degree consanguineous parents. ⋯ The entity is distinct from spondylothoracic dysostosis, which has a higher mortality due to respiratory complications. The patient was not compliant for genetic familiar counseling. At 12-year follow-up, the patient was in periodic respiratory and motor rehabilitation therapy.
-
The purpose of the present study was to describe our single-institutional experience of treating direct carotid-cavernous fistulas (DCCFs) with Willis covered stents (WCSs). ⋯ WCS was proved to be an alternative treatment method for complex DCCFs through reconstruction and preservation of the internal carotid artery. Our study also confirmed the safety, efficacy, and midterm durability of WCSs for complex DCCFs without any serious delayed complications.
-
Case Reports
A pial arteriovenous fistula in infancy as the presenting manifestation of hereditary hemorrhagic telangiectasia.
Pial arteriovenous fistulas (PAVFs) are rare, accounting for 1.6%-4.7% of all intracranial vascular malformations. Often diagnosed in childhood, about 30% are associated with hereditary hemorrhagic telangiectasia. A case of PAVF diagnosed soon after birth and given cerebrovascular therapy 4 months after birth is reported. ⋯ This report describes a case of infant PAVF with heart failure, a giant varix, hydrocephalus, and intraventricular hemorrhage treated by TAE using platinum coils and liquid embolic material.