World Neurosurg
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To identify clinical factors predicting the development of myelopathy in cervical ossification of the posterior longitudinal ligament (OPLL) patients with radiculopathy. ⋯ Nonmyelopathic OPLL patients with radiculopathy and a high occupying ratio were at higher risk of developing myelopathy, and surgical intervention should be recommended in these cases. However, for elderly patients with significant comorbid conditions, the risks and benefits of surgery should be carefully considered.
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Successful resection of arteriovenous malformation (AVM) depends on preoperative assessment of the detailed morphology of the AVM. Simultaneous detailed three-dimensional visualization of the feeding arteries, draining veins, and surrounding structures is needed. The aim of this study was to evaluate the usefulness of high-resolution three-dimensional multifusion medical imaging (HR-3DMMI) for preoperative planning of AVM resection. ⋯ HR-3DMMI technique demonstrated the precise locations of feeding arteries, draining veins, and surrounding important tissues, such as corticospinal tract and arcuate fiber, preoperatively and estimated the appropriate route for resection of the AVM. HR-3DMMI is expected to be a very useful support tool for surgery of AVM.
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Capillary hemangiomata are benign vascular tumors that typically occur in children. They rarely occur in the central nervous system. Intracranial capillary hemangiomata in adults are very rare entities with only 18 cases reported in the literature. We report a case of parasellar capillary hemangiomata that extended into the sella in a 64-year-old woman as well as a review of the literature in adults. ⋯ Capillary hemangiomata related to the sella are very rare and can easily be misdiagnosed on imaging alone. The present case highlights capillary hemangiomata as an important, albeit rare, differential when considering a sellar or parasellar mass.
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It is rare for breast carcinoma to metastasize to the pituitary gland; this finding indicates extensive metastasis of the primary tumor. ⋯ Pituitary gland metastasis is rare and difficult to differentiate from a pituitary adenoma without a pathologic diagnosis. Surgery is the first choice for treatment. Surgery, radiotherapy, and chemotherapy are combined with endocrine therapy to tailor treatment to the results of immunohistochemistry.
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Misoprostol is often used for termination of pregnancy in France and other countries. However, some pregnancies are continued after taking the drug and congenital malformations are known to be the consequence of fetal exposure to misoprostol, among them hydrocephalus. The type of hydrocephalus in case of misoprostol exposure is not known. ⋯ The possible physiopathologic implications of the drug regarding the genesis of this malformation are discussed.