World Neurosurg
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Central neurocytomas are benign tumors accounting for <0.5% of all intracranial tumors. They are usually intraventricular, the most common site being the lateral ventricles, and are associated with good prognosis if they are completely resected surgically. ⋯ Gross total resection should be the goal in all patients with central neurocytoma, but it may be limited because of proximity of the tumor to eloquent areas, especially in large tumors. Intraoperative neuromonitoring plays a pivotal role in maximal safe resection of such large tumors. Tetraventricular atypical central neurocytoma is a very rare entity; and this case could be, to the best of our knowledge, only the second reported case.
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We sought to describe a novel technique in managing a patient with adjacent segment disease at the L5/S1 level. ⋯ This minimally invasive technique is effective in terms of decompression and fixation. It could be used as an alternative method to treat patients with L5/S1 adjacent segment disease.
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Because of the paucity of relevant data, treatment and outcomes in intracranial atypical meningioma (AM) remain unclear. The aim of this study was to find useful factors predicting survival and to evaluate the role of postoperative radiation after surgery. ⋯ GTR is the first choice for patients with AM. We recommend that patients with secondary tumors receive radiotherapy after surgery.
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A 65-year-old man presented with a giant recurrent sacral chordoma after undergoing 7 surgical resections. Neurologic examination revealed urinary incontinence. Magnetic resonance imaging showed a huge mass lesion in the bilateral gluteal regions and multiple metastatic chordomas. ⋯ In addition, multiple metastatic chordomas localized to the pelvic cavity and the subcutaneous layer of the gluteal region showed significant enlargement. The metastatic chordomas were resected in May 2018. At his last follow-up, the patient presented with an indwelling catheter and a colostomy bag, and the recurrent chordoma showed no visible enlargement.
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Venous thromboembolism (VTE) is responsible for many hospital readmissions each year, particularly among postsurgical cohorts. Because early and indiscriminate VTE prophylaxis carries catastrophic consequences in postcraniotomy cohorts, identifying factors associated with a high risk for thromboembolic complications is important for guiding postoperative management. ⋯ Craniotomies for tumor, corticosteroids, advanced age, prolonged length of stay, and discharge to institutional care are significant predictors of VTE readmission. The implication of steroids, coupled with their ubiquity in neurosurgery, makes them a potentially modifiable risk factor and a prime target for VTE reduction in craniotomy cohorts. Furthermore, the fact that dose is proportional to VTE risk in the literature suggests that careful consideration should be given toward decreasing regimens in situations in which use of a lower dose might prove equally sufficient.