World Neurosurg
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Supratentorial extraventricular ependymoma (STEE) is an extremely rare central nervous system (CNS) neoplasm, the clinical characteristics and optimal treatment of which remain unclear. We retrospectively analyzed the clinical characteristics and treatment outcomes of 15 patients with STEE. ⋯ STEE is an extremely rare CNS neoplasm. The histological grade of STEE is an important prognostic factor. Microsurgical resection might play a major role in both initial treatment and treatment of recurrent tumors.
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Flow diversion has become an accepted treatment strategy for aneurysms; however, there are limited data on the use of these devices in small vessels ≤2.5 mm in diameter. ⋯ Flow diverters can be implanted into small vessels with a high rate of technical success and good rates of aneurysm occlusion. Dedicated devices to target these vessels should be developed.
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Endoscopic third ventriculostomy (ETV) has overtaken the use of a ventriculoperitoneal shunt for the treatment of congenital hydrocephalus. Although ETV is relatively safe, several postoperative complications have been reported. One of the least described and understood complications is subdural hygroma following third ventriculostomy. ⋯ Post-ETV subdural hygroma may result from poor absorption of cerebrospinal fluid (CSF) in the subarachnoid space, dysfunction of the stoma with persistence of the ventriculosubdural fistula, or altered CSF cytology, such as hemorrhage. Most of these patients remain asymptomatic and improve with time. Symptomatic patients should be properly evaluated for the cause of the formation of subdural hygroma, which will guide the appropriate interventions.
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Brain involvement of hepatosplenic T cell lymphoma (HSTL) has not been reported so far. ⋯ HSTL can involve the brain. A diagnosis of HSTL involving the brain needs careful systemic evaluation. Timely and precise diagnosis that considers the systemic condition is important for appropriate treatment and better outcome.
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Electromagnetic (EM) navigation has been reported to be a noninvasive and easy-to-use technique. However, the use of metal neurosurgical instruments (e.g., skin hooks, head frames, brain retractors systems) can interfere with the magnetic fields of such systems. We present the freehand technique, a new technique involving the manual manipulation of the emitter of an EM navigation system, which helps to prevent interference caused by metal instruments during surgery. ⋯ During the use of EM navigation systems, the freehand technique with the emitter can prevent interference caused by metal instruments.