World Neurosurg
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The diagnosis and management for juvenile psammomatoid ossifying fibroma (JPOF) of the skull base are challenging, and clinical data are limited. ⋯ The present series of skull base JPOFs showed that radical surgery combined with skull base reconstruction contributed to overall good prognosis. Further studies are needed to evaluate the long-term outcomes and to characterize its pathologic characteristics.
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Subarachnoid hemorrhage (SAH) can be associated with a degree of resulting brain damage and subsequent reorganization of the central nervous system. The aim of this study was to evaluate complication rates and clinical outcome in patients with a previous SAH who were treated for a recurrent or an additional, initially unruptured aneurysm. ⋯ Treatment of recurrent or additional aneurysms in patients with a previous SAH can be performed with acceptable complication rates and morbidity by either surgical or endovascular means.
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This study aimed to analyze the risk factors for secondary new vertebral compression fractures (SNVCFs) after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures. ⋯ Low BMD, high preoperative compression ratio, and high preoperative SI may be predictive factors for SNVCFs. In particular, to prevent AVCF, the injected bone cement should be distributed both evenly and symmetrically along the inferior-to-superior axis and the relative bone cement volume should not be excessive. Bone cement should be injected carefully to avoid upper adjacent intradiscal leakage. Prompt BMD correction is important to prevent SNVCF.
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To assess the sensitivity and specificity of arteriovenous malformation (AVM) nidal component identification and quantification using an unsupervised machine learning algorithm and to evaluate the association between intervening nidal brain parenchyma and radiation-induced changes (RICs) after stereotactic radiosurgery. ⋯ The automated segmentation algorithm was able to achieve classification of the AVM nidus components with relative accuracy. Greater proportions of intervening nidal brain parenchyma were associated with RICs.
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Presacral schwannomas are rare benign tumors that may reach large size before becoming symptomatic. Total surgical removal has been considered the best treatment option. Tumors arising from the presacral area are commonly managed through anterior approaches, whereas posterior approaches are used for pure intrasacral tumors or large lesions with both intra and presacral extension, alone or in combination with anterior approaches. ⋯ The posterolateral trans-sacral ala approach may represent a minimally invasive option in the surgical management of presacral well-circumscribed benign tumors. Spinal navigation could be properly used to facilitate lesion exposure, and to minimize the bone removal. The intraoperative neurophysiological monitoring is an essential tool for the preservation of the lumbosacral nerve roots.