World Neurosurg
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Polycythemia vera (PV) is a myeloproliferative disorder usually characterized by an increase tendency toward thromboembolic events. Spontaneous hemorrhage/bleeding in PV patients is seldom reported in neurosurgical literature. ⋯ Sporadic reports of hemorrhage within the central nervous system in the setting of PV exist and are attributed to microvascular thrombotic events with hemorrhagic conversion. Though rare, spontaneous central nervous system hemorrhage in the absence of vascular malformation or an inciting event such as trauma can occur in the setting of myeloproliferative disorders like PV.
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Posterior communicating artery segment aneurysms are one of the most frequent intracranial aneurysms. Currently, limited data have described the use of the pipeline embolization device (PED) in these aneurysms. ⋯ PED use for treatment of PComA aneurysms resulted in acceptable occlusion rates. The present study did not find that fetal PComA, its origin, or its patency during follow-up had an effect on aneurysm occlusion.
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To investigate the validity of various approaches to extract quantitative measurements of diffusion imaging (i.e., apparent diffusion coefficient [ADC]) to investigate tumors of the central nervous system. In current studies, the region of interest (ROI) for the quantitative measurements are placed arbitrarily according to morphology. Our aim is to investigate how placement patterns influence the ADC estimation in intracranial tumors. ⋯ The positioning of ROI in these measurements is pivotal. Although "whole tumor volume" measurements represent the largest amount of information, multiple seed points can be used as well. However, there must be multiple seeds and their placement must be reported. ADC can be used as a versatile tool for tumor assessment but must be used judiciously and structured to yield comparable results.
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Several differences distinguish brain functioning and behavior of women and men. This article addresses how gender features influence the way one behaves in the workplace, in particular, in neurosurgery. Women experience impostor syndrome, which is a persistent fearing of impropriety, by tending to point out their own fears and express their flaws, underrating themselves. ⋯ According to several authors, female neurosurgeons represent an important component for the future of the discipline and are essential to the field's growth. Nevertheless, young women feel a tension between the "women can have it all" movement and a realistic view of themselves as mothers, partners, employees, and leaders. As a young neurosurgeon, I think that our future is in our hands, it depends on our enthusiasm, on our energy but, above all, it will be bright, since we all are neurosurgeons.
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Distal outflow occlusion and extracranial-intracranial bypass represent a possible option for the surgical management of complex middle cerebral artery (MCA) aneurysm. A limitation of the distal clipping strategy combined to bypass is related to the difficulties in predicting intraoperatively the good blood flow supply to the brain territory distal to the aneurysm and the extent and speed of aneurysmal thrombosis. ⋯ We present the first report of a synergistic intraoperative utilization of ICG-VA and CEUS in studying parenchymal perfusion and aneurysm flow in complex neurovascular procedures.