Journal of neurosurgery
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Journal of neurosurgery · Jul 2019
Classification of the variations of the palmar recurrent branch of the median nerve with special emphasis on angulation.
Iatrogenic nerve injuries are devastating to both the patient and the surgeon. This study focuses on the anatomical relationship of the palmar recurrent branch with the parent median nerve in an attempt to identify higher risk types. ⋯ Close attention should be paid to the potential anatomical variabilities when performing nerve surgeries. For the palmar recurrent branch, the more medial the origin and the greater the angle it makes with the median nerve, the more dangerous it is. This classification is helpful in unifying the language and comparing results.
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Journal of neurosurgery · Jul 2019
ReviewCavernous angiomas: deconstructing a neurosurgical disease.
Cavernous angioma (CA) is also known as cavernoma, cavernous hemangioma, and cerebral cavernous malformation (CCM) (National Library of Medicine Medical Subject heading unique ID D006392). In its sporadic form, CA occurs as a solitary hemorrhagic vascular lesion or as clustered lesions associated with a developmental venous anomaly. In its autosomal dominant familial form (Online Mendelian Inheritance in Man #116860), CA is caused by a heterozygous germline loss-of-function mutation in one of three genes-CCM1/KRIT1, CCM2/Malcavernin, and CCM3/PDCD10-causing multifocal lesions throughout the brain and spinal cord. ⋯ Pathobiological mechanisms related to CA include inflammation and immune-mediated processes, angiogenesis and vascular permeability, microbiome driven factors, and lesional anticoagulant domains. These mechanisms have motivated the development of imaging and plasma biomarkers of relevant disease behavior and promising therapeutic targets. The spectrum of discoveries about CA and their implications endorse CA as a paradigm for deconstructing a neurosurgical disease.