World Neurosurg
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Neurocutaneous melanosis (NCM) is a rare congenital syndrome. Except for some retrospective studies, information on clinical follow-up and management of these patients are limited. This study aimed to review our experience on diagnostic protocol and clinical follow-up of patients with NCM in a referral children's hospital in Iran. ⋯ There are no specific guidelines for management of NCM due to the rarity of the disease. This study proposed modifications in diagnostic criteria, as well as recommendations for follow-up surveillance.
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This study established novel technique nuances in surgery for ventral foramen magnum meningiomas (vFMMs) via a dorsal lateral approach. ⋯ We established a minimal retraction principle, in which the selection of 2 safe zones as the entrance of the surgical corridor, tumor removal from the inferior to superior direction, and debulking followed by devascularization were the key elements to implement the minimal retraction principle in vFMM surgery.
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Influence of microcatheter position on first-pass success of thrombectomy for acute ischemic stroke.
In acute ischemic stroke, patient outcomes can be improved by first-pass successful recanalization of the occluded vessel. This study investigated whether microcatheter position could influence the success of first-pass recanalization. ⋯ First-pass microcatheter insertion into M2P may contribute to fast successful recanalization in patients with M1 occlusion who undergo intra-arterial thrombectomy using stent retrievers.
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Acromegaly is a rare, chronic disorder that mostly results from growth hormone (GH)-secreting pituitary adenoma. Transsphenoidal surgery is the first-line treatment of this adenoma. This study aimed to identify factors associated with remission outcome in patients with GH-secreting pituitary adenomas following transsphenoidal surgery. ⋯ Preoperative insulin-like growth factor 1 index ≥2.5 and Knosp classification grade 3-4 were important prognostic factors that determined remission outcome after treatment. Patients who have both of these poor prognostic factors should be aggressively treated with surgery, medication, and probably radiation to optimally control the disease.
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One possibly problematic feature of lumboperitoneal shunt (LPS) placement involves inaccuracy in handling the shunt valve compared with ventriculoperitoneal shunt. Flushing the valve to ascertain shunt patency and adjusting the valve pressure in LPS are often more difficult than with ventriculoperitoneal shunt, particularly when the valve is routinely located in abdominal fat. To overcome this inaccuracy, we applied a simple alteration to the usual LPS procedure. We changed the valve location from the abdominal fat to a lumbar posterior site where the paravertebral spinal muscle, in contrast to the nonsupportive abdominal fat, offers a good anchoring point for valve implantation. ⋯ In this series, our modification increased the accuracy of handling the valve without increasing discomfort.