World Neurosurg
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To evaluate the clinical efficacy and feasibility of one-stage surgical treatment for consecutive multisegment thoracic spinal tuberculosis with kyphosis by posterior-only debridement, interbody fusion, and instrumentation. ⋯ One-stage posterior surgery of debridement, interbody fusion and instrumentation could serve as an efficient way to cure patients with consecutive multisegment thoracic spinal tuberculosis.
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Dural presentation of a cavernous hemangioma is a rare occurrence. Classically an intraparenchymal lesion with varying symptomatology including mostly headaches, seizures, and neurologic deficits depending on its location, a few cases have been reported along the convexity of the brain, even less eroding the calvaria, with none occasioning abnormal movements as the initial presentation. This is a case of a 67-year-old male who presented to the clinic for atypical progressive choreiform movements of the right side of his body and a soft subgaleal mass. ⋯ A craniotomy was performed on January 29, 2018, during which the tumor was resected along with the invaded dura mater and calvaria. Pathology report was positive for cavernous hemangioma, an unexpected diagnosis based on the tumor's characteristics. Following the surgery, the patient recovered completely without residual symptoms, suggesting a compressive mass effect causing the atypical movement disorders.
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There is a lack of literature guiding treatment of giant cell glioblastoma (gcGBM), a rare subtype of glioblastoma (GBM). We used a national hospital-based registry to explore treatment patterns and outcomes associated with gcGBM. ⋯ gcGBM has favorable prognosis compared with GBM and should be aggressively managed with trimodal therapy. Prospective studies of gcGBM are warranted to better characterize gcGBM treatment outcomes.
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Dysfunction of endothelial cells (ECs) constitutes a critical factor in the formation of intracranial aneurysms (IAs). However, little is known about the response of ECs to hemodynamic insults and its contribution to IA formation. ⋯ The potential mechanism, that IAs are always localizing in the bifurcation apices, may be that the endothelium injury of vessel wall can be induced by different hemodynamic conditions. Hemodynamic changes in artery bifurcation may initiate the formation of IAs.
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The optimal approach of blood blister-like aneurysms (BBAs) is debated. Wrapping has been reported to be an effective strategy, but artificial materials were often used. In addition, perforator protection was difficult using this technique. In this case, we report a ruptured BBA of the left internal carotid artery (ICA) treated with a clip-reinforced wrapping technique using a Y-shaped autologous temporalis fascia to protect the posterior communicating artery (PComA). The outcome was favorable. ⋯ Clip-reinforced wrapping technique using a Y-shaped temporalis fascia may be an effective method for treating BBAs located opposite the PComA origin. Long-term follow-up and large sample-size studies, however, are necessary to validate this approach.