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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Management of patients with optic nerve sheath meningiomas (ONSMs) is controversial and the treatment strategy in this patient group is still up for discussion. Transnasal endoscopic orbital and optic nerve decompression aims to reduce the pressure in the orbit and on the optic nerve and thereby prevent vision loss. This article presents material from 7 cases of transnasal endoscopic orbital decompression. ⋯ The current report of 7 patients with ONSM shows promising results for this surgical procedure as 4 out of 7 patients experienced improvement in their vision at follow-up examinations. The 2 patients who experienced deterioration of vision already had severely reduced vision preoperatively, which indicates that surgery should be considered before the vision becomes significantly reduced.
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We sought to investigate the value of combining intrauterine cerebral blood flow changes with brain electrical activity examination in evaluating the prognosis of brain injury. ⋯ Combining the assessment of intrauterine cerebral blood flow changes with cerebral electrical activity examination proved beneficial in diagnosing the prognosis of brain injury and provided an important reference for early clinical intervention.
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Advances in the use of flow diversion (FD) now extend to bifurcation aneurysms; herein, we compare thromboembolic events in patients with internal carotid artery (ICA) aneurysms treated with and without exclusion of the anterior cerebral artery (ACA). ⋯ Thromboembolic events can occur in distal ICA aneurysms treated with FD, but no significant association was seen with covering the ACA origin.
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To identify high-risk patients for delayed postoperative hyponatremia (DPH) early, we constructed a simple and effective scoring system. ⋯ This scoring system for predicting DPH has an area under the receiver operating characteristic curve of 0.856 (95% CI, 0.787-0.925), indicating moderate to good predictive value for DPH in our cohort, but further prospective external validation is needed.