World Neurosurg
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There is limited information on the impact of smoking on postcraniotomy mortality. In this study we used the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to examine this issue. ⋯ This study identified ≥30 pack-years as a risk factor for male patients undergoing craniotomy as treatment for neurovascular diseases.
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We sought to determine whether systemic inflammatory markers (SIMs) can be used to predict the pathological grade of meningioma before surgery. ⋯ SIMs obtained from routine preoperative laboratory testing had a limited ability to differentiate low- and high-grade meningioma in our cohort of 672 patients. Further prospective, multicenter studies with larger sample sizes are warranted to confirm this finding.
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Brain metastases (BMs) are classically well-circumscribed lesions. Still, the amount of edema in these neoplasms suggests either mechanisms of infiltration or defense. A better understanding of the mechanisms within the edema of BMs seems reasonable to preoperatively identify areas of potential infiltration and resect them. BMs represent tumors with high energy demand and cell turnover; therefore, they qualify for preoperative investigation with phosphorus-31 magnetic resonance spectroscopy (31PMRS), which reveals information about those characteristics. ⋯ 31PMRS in BMs provides information on metabolic changes in tumor and surrounding edema. There is proof of enhanced metabolism in tissue without histologic tumor manifestation.
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Although superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis is a beneficial treatment for hemorrhagic moyamoya disease, indeterminate mechanisms can cause rebleeding even after successful bypass surgery. We describe a case with a prominent collateral from the lenticulostriate artery (LSA) causing multiple recurrent hemorrhages after successful STA-MCA anastomosis. ⋯ Lenticulostriate anastomotic branches distributed medially to the anterior cerebral artery territory should be given more attention as an intractable cause of hemorrhage after successful STA-MCA anastomosis. Although challenging, direct bypass targeting the area reached by collateral vessels could be considered an alternative treatment strategy for this pathologic condition.
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The combined transpetrosal approach is a complicated skull base surgery with a high degree of difficulty. Herein, we made a 3-dimensional (3D) printed petrous bone with color-coded anatomic sites and evaluated its usefulness as a model to practice drilling associated with combined transpetrosal surgery. ⋯ These results indicate that our 3D printed model is very useful for practice with craniotomy and petrosectomy drilling, necessary in the combined transpetrosal approach.