World Neurosurg
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Awake craniotomy for brain lesions in or near eloquent brain regions enables neurosurgeons to assess neurologic functions of patients intraoperatively, reducing the risk of permanent neurologic deficits and increasing the extent of resection. ⋯ Introducing awake craniotomy to a tertiary non-university-affiliated neurosurgery department is feasible and resulted in reasonable operation times and complication rates and high patient satisfaction.
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The complex structure around the upper cervical spine makes surgical treatment difficult. the present study aimed to analyze how patients with ossification of the longitudinal ligament (OPLL) involving the C2 were managed and to compare the surgical outcomes according to the C2 involvement. ⋯ Both of C2 involvement from OPLL and surgery including the C2 did not affect clinical outcomes. The posterior decompressive surgery is safer and more effective than the anterior approach regarding the development of surgery-related complications.
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Case Reports
Techniques and outcomes of Gore-Tex clip-wrapping of ruptured and unruptured cerebral aneurysms.
Some aneurysms without a definable neck and associated parent vessel pathology are particularly difficult to treat and may require clipping with circumferential wrapping. We report the largest available contemporary series examining the techniques of Gore-Tex clip-wrapping of ruptured and unruptured intracranial aneurysms and patient outcomes. ⋯ Gore-Tex has excellent material properties for circumferential wrapping of aneurysms and parent arteries. It is inert and does not cause a tissue reaction or granuloma formation. Gore-Tex clip-wrapping can be used safely for microsurgical management of ruptured and unruptured cerebral aneurysms with acceptable recurrence and rehemorrhage rates.
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Primary intracranial alveolar soft-part sarcoma: Report of two cases and a review of the literature.
Alveolar soft part sarcoma (ASPS), a rare malignant soft-tissue sarcoma affecting mainly adolescents and young children, frequently metastasizes to the brain. Primary intracranial ASPS, however, is extremely rare. We present 2 cases of primary intracranial ASPS without demonstrable systemic lesions. ⋯ This is the fifth report about primary intracranial ASPS. We herein present the clinical pathologic characteristics, imaging features, and differential diagnosis of primary ASPS of the brain. Gross total resection is the most effective therapeutic option for primary intracranial ASPS.
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We reviewed our experience with salvage surgery following failed gamma knife radiosurgery (GKS) for vestibular schwannomas. ⋯ A surgical indication after GKS should be carefully considered because of the natural regression of transient tumor expansion with time, and surgical resection is limited to subtotal or partial removal for functional preservation. Careful follow-up is necessary in patients with tumor regrowth several years after GKS due to delayed radiation effects.