World Neurosurg
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Case Reports
Stent-Assisted Coil Embolization for Ruptured Intracranial Dissecting Aneurysms Involving Essential Vessels.
The optimal treatment strategy for ruptured intracranial dissecting aneurysms involving essential vessels remains controversial. The aim of this study was to review the safety and efficacy of endovascular treatment at our center. ⋯ Careful follow-up is necessary after endovascular coiling for ruptured dissecting aneurysm involving essential vessels. Although additional treatment might be required, stent-assisted coiling could be a less invasive and feasible method for handling these difficult lesions.
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The present study introduced ultrasound volume navigation (UVN) to reduce the radiation exposure and puncture time of percutaneous transpedicular puncture in percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). ⋯ UVN could obviously reduce the radiation exposure and puncture time of percutaneous transpedicular puncture in PVP and PKP.
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Using proper surgical technique, schwannomas can be resected safely, with a low recurrence rate and high likelihood of improvement in symptomatology. There are multiple peritumoral tissue layers, and finding the correct plane is critical to safe tumor enucleation. The contents of the pseudocapsule tissue surrounding a schwannoma are not well described, and the consequences of resecting or leaving pseudocapsules are unknown. ⋯ The pseudocapsule surrounding a schwannoma occasionally contained nerve tissue and blood vessels. While a microscopic focus of tumor was often found in this tissue layer, recurrence is exceedingly rare and did not occur in this case series. The risk of undue pseudocapsule dissection likely outweighs any negligible benefit from microscopic cytoreduction.
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Although Tarlov cysts (TC) were first described in 1938, our understanding of these common spinal lesions remains poor. As TCs represent incidental findings in the vast majority of cases, evidence to guide their management is limited to small case series. ⋯ This is the first report demonstrating growth of TCs. The patient underwent open surgical reduction of the symptomatic TCs, leading to improvement in her symptoms.
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Sellar arachnoid cysts are a rare occurrence but may impinge on vital parasellar anatomy and thus are often symptomatic. The etiology of sellar arachnoid cysts is contentious, fueled by heterogeneity in cyst wall structure and contents between cases. The "ball-valve" mechanism is 1 of 2 predominant theories describing their formation, which contends that an aperture in the diaphragm allows cerebrospinal fluid to enter the cyst, propelled by pulsatile flow, but its egress is obscured by the pituitary during the ebb of the pressure wave. ⋯ Intraoperative video evidence during arachnoid cyst fenestration supports the "ball-valve" theory of sellar arachnoid cyst development.