World Neurosurg
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The Pipeline embolization device (PED) is commonly used for the treatment of distal internal carotid artery (ICA) aneurysms, which often require placing the stent across the origin of the precommunicating segment of the anterior cerebral artery (ACA-A1). We sought to characterize the clinical and angiographic consequences of this maneuver. ⋯ The PED can be used to treat aneurysms with deployment from the MCA-M1 to the ICA without resulting in ACA stroke. Ipsilateral A1 segment dominance might be predictive of continued blood flow into the ACA after deployment at this location.
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Fluorescein-guided surgery of high-grade gliomas (HGGs) increases the extent of tumor resection but its efficacy has been questioned, especially for tumors located close to functional networks. In these cases, navigated transcranial magnetic stimulation (nTMS) may be used to plan and guide a safe resection. The aim of this study was to assess the impact of these techniques combined with intraoperative neurophysiologic mapping (IONM) to achieve the maximal safe resection of tumors located in the motor area. ⋯ This study supports the role of the combination of sodium fluorescein-guided resection and nTMS-based planning for surgery of HGGs close to the motor pathway. This multimodal approach in combination with IONM may lead to customized preoperative planning, increased extent of resection, and improved functional outcome, compared with standard IONM-guided surgery.
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To provide anatomic evidence of preoperative assessment of oblique lumbar interbody fusion (OLIF) for Chinese patients. ⋯ OLIF can be a good choice for lumbar intervertebral fusion, including L5-S1 segment, in most Chinese patients. Older women are likely to have more scope of OLIF surgery. As a routine preoperative examination, lumbar magnetic resonance imaging is of great importance to OLIF surgery preoperative assessment.
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Case Reports
Cerebellar metastasis of unknown primary neuroendocrine carcinoma: report of a case mimicking hemangioblastoma.
Neuroendocrine carcinoma (NEC) originates with neuroendocrine cells and is mainly found in the pancreas, lungs and gastrointestinal tract. We surgically treated a case of primary unknown NEC with only cerebral metastasis that mimicked hemangioblastoma. Recurrence was seen at the fornix, and no primary lesion had been identified as of 2 years after treatments despite careful examination. ⋯ We treated brain metastasis from NEC of unknown primary and mimicking hemangioblastoma using only local treatment. When an enhancing, single, solid tumor is seen in the cerebellum, brain metastasis from NEC of unknown primary is 1 differential diagnosis.
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Synovial cysts are most commonly found in the lumbar spine and are associated with low back pain and radiculopathy. Frequent use of imaging modalities has led to an increase in intraspinal synovial cyst identification. Treatment typically ranges from conservative measures to surgical decompression, but spontaneous resolution has previously been reported. Here, we present the first report of symptomatic lumbar synovial cyst resolution after a traumatic fall. ⋯ The diagnosis of synovial cysts are increasing in frequency due to their ease of identification with computed tomography and MRI. For cases of refractory pain and/or neurologic deficits, surgical decompression is usually necessary. In rare instances, synovial cysts may spontaneously regress or resolve secondary to other events. This is the first description of resolution after a traumatic fall. Due to limited data on this topic, this report may provide additional insight into the pathophysiology of synovial cyst formation and resolution.