World Neurosurg
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Many morphological and hemodynamic parameters have been proposed as promising aneurysm rupture status discriminators. Besides, a clear dichotomy between sidewall and bifurcation aneurysms was reported. In this study, we strove to evaluate the contribution of many reported morphological and hemodynamic parameters to retrospective rupture status determination in bifurcation aneurysms independent of patients' characteristics. ⋯ Higher aspect ratio and LSA are good indicators for bifurcation aneurysm rupture. MANs with different rupture status might be a useful disease model in which many factors are balanced to investigate possible features linked to aneurysm rupture.
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World Health Organization grade II astrocytomas (AII) are the commonest low-grade glioma subset, but their prognostic factors are subject to debate. This institutional study aimed to identify prognostic factors in lobar AII. ⋯ Patients with World Health Organization grade II astrocytomas have better overall survival if their tumor is nonenhancing, amenable to surgical resection, and exhibits the IDH1 mutation. These factors should be used to guide patient management and inform prognosis.
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Trans-facial vein (FV) embolization via the internal jugular vein is an alternative approach to embolization of carotid cavernous fistulas (CCFs). The purpose of this study is to report the anatomic variation of FVs and our experience of trans-FV embolization of CCFs. ⋯ Trans-FV embolization is an effective and safe method to manage CCFs with anterior drainage. However, anatomic variations of the FV exist, and a careful work-up of fistula venous drainage before trans-FV embolization is essential to reduce erroneous attempts, procedure time, and periprocedural risk.
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Benchmarking of outcomes and individualized risk prediction are central in patient-oriented shared decision making. We attempted to create a predictive model of complications in patients undergoing benign intracranial tumor resection. ⋯ Our models can provide individualized estimates of the risks of postoperative complications based on preoperative conditions and potentially can be used as an adjunct for decision making in benign intracranial tumor surgery.
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Skull base lesions are challenging to treat and may be managed using several approaches each with its own advantages and limitations. In selected cases, a modular, combined, multiportal approach could overcome the limits of a single approach and respond well to the needs of the patient. ⋯ The multiportal combined transorbital transnasal endoscopic approach is a safe and effective procedure for management of selected complex skull base lesions that is able to capitalize on the advantages and overcome the limitations of each single approach. This combined approach offers a multiperspective view of the spaces and allows for a more synergized procedure, especially when dealing with multicompartmental lesions.