World Neurosurg
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A discrepancy between definitions of morphologic parameters describing cerebral aneurysms across studies leads to conflicting results concerning performances of these factors and threshold values for rupture status prediction. The aim of the study was to evaluate how various definitions of morphologic parameters may influence the prediction of the risk for aneurysm rupture. ⋯ Different definitions of aneurysm parameters affect various rupture risk determination. AR defined as Hmax/Nwidth and aneurysm location with significantly higher rupture risk of anterior communicating artery aneurysms are independent predictors for aneurysm rupture.
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To compare the safety and efficacy between Woven EndoBridge (WEB) embolization and conventional coiling for treatment of unruptured intracranial aneurysms using a propensity score-matched analysis. ⋯ Treatment of unruptured aneurysms with the WEB provides potentially higher aneurysm occlusion rates than conventional coiling while having similar complication rates and no additional morbidity.
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Intramedullary glial neoplasms affecting the entire spinal cord from the cervicomedullary junction to conus medullaris are termed holocord tumors. Pilocytic astrocytomas are relatively uncommon tumors forming holocord involvement. Hitherto 24 holocord astrocytoma cases were reported in the literature. Here, a case of an adult holocord pilocytic astrocytoma was presented. ⋯ Reported holocord pilocytic astrocytomas in the relevant literature cases were reviewed. When evaluating magnetic resonance imaging scans of adult patients with various neurologic symptoms, i.e., weakness and fecal and urinary incontinence, pilocytic astrocytoma should be considered among differential diagnoses of intramedullary mass lesions.
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To compare the clinical and radiologic outcomes of 3 anterior surgical techniques for the treatment of 3-level cervical spondylotic myelopathy (CSM) and the evolution of intramedullary T2-weighted increased signal intensity (ISI). ⋯ For patients with 3-level CSM with ISI on T2-weighted MRI, HDF can be considered as the optimal technique that achieves better clinical and radiologic outcomes than the ACDF or ACCF procedure. HDF also has a better postoperative regression of ISI compared with the ACDF or ACCF procedure, which may potentially be an important indicator for improving surgical outcomes.
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Dorsal spinal instrumentation with cervical pedicle screws (CPS) and rod constructs is performed for numerous pathologies of the cervical spine, although technically demanding. Screw misplacement is biomechanically disadvantageous and carries the risk of neurovascular sequelae. The aim of this study was to assess the accuracy of patient-specific, template-guided CPS placement from C2 to C7 compared with the freehand technique. ⋯ In a cadaver model, template-guided CPS placement has a significantly greater accuracy than the freehand technique. This accuracy is comparable with navigated techniques reported in the literature.