World Neurosurg
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Vascular anatomic variations are very common in the population, but their coexistence with life-threating vascular malformations remains unclear. The objective of the study was to assess the correlation between the presence of anatomic variants of both carotid and main cerebral arteries and the occurrence of cerebral aneurysms. ⋯ There is an evident correspondence between the presence of vascular anatomic variants (abnormal origin of the carotid arteries, hypoplasia, or duplication of the main cerebral artery) and the occurrence of cerebral aneurysms.
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Persistent primitive trigeminal artery (PPTA) is a rare abnormal carotid-basilar anastomosis. In rare circumstances, PPTA can be associated with some cerebrovascular anomalies, including arteriovenous malformation, intracranial aneurysm, carotid cavernous fistula, and moyamoya disease (MMD). ⋯ The pathogenesis of the coexistence of PPTA and MMD, PPTA and intracranial aneurysm, and MMD and intracranial aneurysm is still unknown. According to the literature, congenital factor and hemodynamic stress may play an important role in the formation of these vascular anomalies. In case of hypoplasia of the vertebrobasilar system, PPTA could also be used as a route for endovascular coiling for some specific aneurysms in the posterior circulation. To our knowledge, this is the first report of such a case.
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This original report describes the outcome of a cranioplasty at long-term follow-up. A large calvarial bone defect of a child was reconstructed with a bioactive and biostable nonmetallic implant. ⋯ In the future, a synthetic cranioplasty material that is able to integrate with cranial bone may be considered superior to cryopreserved bone grafts in younger age groups.
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Whether the risk of rupture of a cerebral arteriovenous malformation (AVM) increases during pregnancy remains controversial. Moreover, it is unclear whether the number of pregnancies correlates with AVM rupture risk. We report a case of ruptured AVM during the fifth pregnancy. ⋯ This report suggests that the risk of AVM rupture persists even after multiple deliveries. Intracranial hemorrhage should be suspected in pregnant patients who underwent multiple deliveries, and a rapid diagnosis and appropriate treatment are necessary.
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Spinal ependymomas are rare, with an incidence of 1 per 100,000. Given the paucity of data for higher grade II and III disease, the management and patterns of care require further investigation. ⋯ Approximately 40% of patients with grade III ependymomas do not receive immediate adjuvant therapy, which may be related to distance from a facility. Patients with this rare tumor may benefit from multidisciplinary care at facilities with a larger volume.