World Neurosurg
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Recent advancements in understanding the molecular basis of gliomas and new concepts of neuronal plasticity have shown the importance of maximal resection in gliomas to improve progression-free overall survival. Awake craniotomies with intraoperative cortical and subcortical mapping have helped to achieve this aim while allowing us to preserve executive function including language. Language mapping becomes a daunting task in individuals who are bilingual because of the complexity of varied cortical representation of different languages. ⋯ Advancements in anesthesia and neuromonitoring have further allowed for long awake periods, permitting complex language tasks to be tested intraoperatively. The results obtained from this case study have allowed us to further plan for awake surgeries for patients with bilingualism. With understanding bilingual representation of languages, we hope to achieve maximal resection with minimal postoperative deficits.
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We sought to clarify the expression characteristics and prognostic significance of transforming growth factor (TGF)-β3 in cranial meningiomas. ⋯ TGF-β3 expression levels gradually declined with the increase of WHO grade and were lower in recurrent meningiomas than in primary meningiomas. Besides, low TGF-β3 expression was found to predict tumor recurrence and mortality in meningiomas based on univariate analysis.
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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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To define, from a series of surgically treated meningiomas of the posterior fossa with dural attachment above the dural sinuses, the best management of the sinus invasion according to the pattern of venous circulation. ⋯ In patients with posterior fossa meningiomas, we suggest to safety resect the involved sinus segment only when completely occluded. If the sinus lumen is not invaded or the tumor lies on the side of the unique or dominant transverse sinus, it should be preserved. This results in no or negligible risk of venous infarction and rather low recurrence rate.
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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.