World Neurosurg
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Multicenter Study
Effect of Fetal Posterior Circulation on Efficacy of Flow Diversion for Treatment of Posterior Communicating Artery Aneurysms: A Multi-Institutional Study.
Flow diversion (FD) has emerged as an effective treatment modality for aneurysms of the posterior communicating artery (PCOM). Whether or not a fetal posterior circulation (FPC) affects PCOM aneurysm occlusion rates after FD remains undetermined. ⋯ Our results indicate reduced efficacy of FD for the treatment of PCOM aneurysms associated with a FPC. These findings may influence treatment selection for aneurysms at this location.
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The carotid sinus nerve branches off the glossopharyngeal nerve just after its appearance from the jugular foramen, descends along the internal carotid artery, and enters the carotid sinus. There have been many studies of the pathway and the course of the carotid sinus nerve and its communications with surrounding nerves. ⋯ Acknowledgment of its anatomic diversity can be important in specific operations dealing with this area. Herein we review the anatomy, variations, pathology, and clinical applications of the carotid sinus nerve.
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The neutrophil-to-lymphocyte ratio (NLR) reflects the balance between innate and adaptive inflammatory responses. This study intended to evaluate parameters associated with admission high NLR and its impact on clinical outcome in patients with primary intraventricular hemorrhage (PIVH). ⋯ NLR tended to be associated with 90-day clinical outcomes of patients with PIVH and exhibited independent predictive power for pneumonia in PIVH.
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Very small intracranial aneurysms (VSIAs) are challenging to treat because aneurysm tearing and clip slippage can occur during neurosurgical clipping. In this study, we introduce and share our experience with cotton-assisted clipping of VSIAs. ⋯ Cotton-assisted clipping could prevent aneurysm clip slipping and aneurysm rupture and facilitate the repair of aneurysm neck tears. This technique is a useful alternative therapy for VSIAs.
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Comment Letter
Cerebral granuloma mimicking malignant neoplasm in a patient with seizures 21 years after head trauma.
Chronic posttraumatic cerebral granuloma is a rare, delayed complication of traumatic brain injury. Because of its late onset of symptoms and atypical appearance, the correct diagnosis of this rare lesion is difficult. ⋯ Chronic cerebral granuloma should be considered in the differential diagnosis of a novel or recurrent mass detected in patients with a history of traumatic brain injury or prior surgery. Moreover, the retained foreign bodies in the superficial or nonfunctional area of the brain should be thoroughly examined and removed at the time of injury, particularly in open brain trauma.