World Neurosurg
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Review Meta Analysis
Vessel Wall Imaging of Intracranial Aneurysms: Systematic Review and Meta-analysis.
Vessel wall imaging (VWI) is emerging as a novel imaging tool for the management and risk stratification of patients with intracranial saccular aneurysms. Our objective was to compare the rates of wall enhancement in unstable (ruptured, growing, or symptomatic) and stable aneurysms and assess the ability of VWI with high-resolution magnetic resonance imaging to distinguish between these 2 entities. This study was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, and eligible studies were identified through a comprehensive literature review. ⋯ There is a statistically significant association between vessel wall enhancement and aneurysm instability. Importantly, the lack of wall enhancement is a strong predictor of aneurysm stability. VWI could potentially provide new insights in the management of intracranial aneurysms.
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Review Case Reports
Multiple Extradural Spinal Meningiomas in a Patient with Acquired Immunodeficiency Syndrome: Case Report and Literature Review.
Purely extradural spinal meningiomas are uncommon. Due to their typical location in the neural foramen, they are often mistaken for schwannomas, neurofibromas, and epidural metastases. In addition, comorbid conditions such as immunodeficiency may obscure the diagnosis. We present a case of extradural spinal meningiomas in a patient with human immunodeficiency virus (HIV). This is the first reported case of multiple extradural spinal meningiomas in 2 separate regions of the spine. ⋯ Our experience with this 40-year-old male with AIDS who presented with radicular symptoms due to multiple purely extradural meningiomas underscores the importance of considering meningioma as a possible diagnosis in patients with tumors of the neural foramina. In addition, a wide differential diagnosis should be made for patients with spinal lesions and history of HIV, including illnesses that are related to immunodeficiency and those that are not.
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Review Case Reports
A Rare Case of Malignant Craniopharyngioma Reactive to Adjunctive Stereotactic Radiotherapy and Chemotherapy: Case Report and Literature Review.
Malignant craniopharyngioma or anaplastic craniopharyngioma was first reported in 1987 by Akachi and colleagues. It has malignant clinical and histological features, remarkably rapid progression, atypical pathology like squamous cell carcinoma, and a poor prognosis. To date, 17 cases of malignant craniopharyngioma have been reported, most of which were secondary malignant tumors. In classic benign craniopharyngioma, adjunctive treatment after gross total removal is not necessary, but in cases of malignant tumors, adjunctive treatment is important. ⋯ Adjunctive gamma knife stereotactic radiosurgery and chemotherapy for malignant craniopharyngioma affects follow-up strategies, we propose the need for a revision to the World Health Organization classification regarding the evaluation of malignant craniopharyngioma.
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Therapeutic strategies for managing hemorrhagic moyamoya disease (MMD) remain controversial. In this study, we investigated the optimal therapy for hemorrhagic MMD. ⋯ Surgical revascularization, especially a direct bypass regimen, may be the optimal strategy for treating hemorrhagic MMD.
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Review Case Reports
Clipping of a Pediatric Pial Arteriovenous Fistula Located at Basilar Artery Tip Using a Hybrid Trapping-Evacuation Technique.
Intracranial pial arteriovenous fistulas (PAVFs) are rare cerebrovascular lesions with high mortality rates. We report a rare case of pediatric PAVF at the basilar artery tip and its treatment with surgical clipping aided by a trapping-evacuation technique in a hybrid operating room. ⋯ The successful obliteration of the lesion is reported. In addition, a brief review of literature comparing endovascular embolization, surgical disconnection, and hybrid technique for treatment of PAVF is included.