World Neurosurg
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Case Reports
A modified Anterior Petrosectomy Approach for Resection of Petroclival Meningioma; with management of complications.
Due to deep location and for being adjacent to neurovascular structures, petroclival meningiomas (PCMs) are generally considered to be associated with a high rate of recurrence and cranial nerve deficits.1 This video presents a 49-year-old female patient reporting right trigeminal neuralgia for more than 1 year. The incidence of this symptom with PCMs is about 5%.2 According to the classification system proposed by Kawase et al.3 and Ichimura et al.,4 this is a tentorium type PCM. ⋯ The treatments to the intraoperative trochlear nerve injury and temporal bridging vein occlusion are displayed (Video 1). The patient gave verbal consent for participating in the procedure and surgical video.
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Meningiomas are the most frequent primary intracranial tumor. While histological grade and grade of excision are established predictors of recurrence, the predictive ability of other clinical features, such as the role of radical excision of dural attachment and postoperative radiation therapy in intermediate-risk groups, remains unknown. ⋯ WHO grade and Simpson grade are independent predictors of recurrence in meningiomas. Regardless of WHO grade, gross total resection must be performed when possible, and postoperative radiation therapy may be recommended in grade 2 meningiomas.
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The treatment of symptomatic Tarlov cysts remains a controversial topic within neurosurgery. We describe our experience with patients who underwent surgical intervention for sacral Tarlov cysts at a single institution. General and disease-specific outcome measures were used to assess health-related quality of life. ⋯ Our longitudinal series demonstrated patient-reported improvement following surgery for symptomatic sacral Tarlov cysts using a validated disease-specific health-related quality of life scale through 12 months after surgery. Patient age and preoperative duration of symptoms were not correlated with outcome.
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Acute upper airway compromise is a rare but catastrophic complication after anterior cervical discectomy and fusion. This study aims to develop a score to identify patients at risk of acute postoperative airway compromise (PAC). ⋯ The acute PAC score demonstrates strong performance characteristics. The PAC score might help identify patients at risk of upper airway compromise caused by surgical site abnormalities.
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This study aimed to investigate the causes of lumboperitoneal (LP) shunt failure and determine risk factors for lumbar catheter fracture. ⋯ Excessive lumbar lordosis is a risk factor for lumbar catheter fracture in patients undergoing LP shunting. Younger age and higher level of postoperative activities of daily living might also be associated with lumbar catheter fracture.