World Neurosurg
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The Pipeline Embolization Device (PED) has been increasingly used for the treatment of posterior circulation aneurysms. The purpose of the present study was to examine the clinical and angiographic outcomes of patients with vertebrobasilar aneurysms treated with the PED. ⋯ Our results show that Pipeline embolization of vertebrobasilar aneurysms is associated with acceptable occlusion and complication rates.
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The supraorbital keyhole approach through an eyebrow incision has been a potentially less invasive approach as an alternative to the standard pterional craniotomy. We aimed to review procedures for anterior and middle cranial fossa lesions and identify lessons learned from addressing various pathologies through this approach. ⋯ The supraorbital keyhole approach may be safely used for various lesions within the anterior and middle cranial fossa. The effectiveness and limitations of this approach and possible complications are discussed. This is a valuable approach for selected patients.
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Vascular anatomic variations are very common in the population, but their coexistence with life-threating vascular malformations remains unclear. The objective of the study was to assess the correlation between the presence of anatomic variants of both carotid and main cerebral arteries and the occurrence of cerebral aneurysms. ⋯ There is an evident correspondence between the presence of vascular anatomic variants (abnormal origin of the carotid arteries, hypoplasia, or duplication of the main cerebral artery) and the occurrence of cerebral aneurysms.
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This original report describes the outcome of a cranioplasty at long-term follow-up. A large calvarial bone defect of a child was reconstructed with a bioactive and biostable nonmetallic implant. ⋯ In the future, a synthetic cranioplasty material that is able to integrate with cranial bone may be considered superior to cryopreserved bone grafts in younger age groups.
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Persistent primitive trigeminal artery (PPTA) is a rare abnormal carotid-basilar anastomosis. In rare circumstances, PPTA can be associated with some cerebrovascular anomalies, including arteriovenous malformation, intracranial aneurysm, carotid cavernous fistula, and moyamoya disease (MMD). ⋯ The pathogenesis of the coexistence of PPTA and MMD, PPTA and intracranial aneurysm, and MMD and intracranial aneurysm is still unknown. According to the literature, congenital factor and hemodynamic stress may play an important role in the formation of these vascular anomalies. In case of hypoplasia of the vertebrobasilar system, PPTA could also be used as a route for endovascular coiling for some specific aneurysms in the posterior circulation. To our knowledge, this is the first report of such a case.