Neurosurgery
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Endoscopic third ventriculostomy (ETV) has been shown to be a sufficient alternative in the surgical treatment of occlusive hydrocephalus. To elucidate the ongoing discussion of timing, indication, and surgical technique, a retrospective analysis of 100 consecutive ETVs was conducted. ⋯ ETV is most effective in treating uncomplicated occlusive hydrocephalus caused by aqueductal stenosis and space-occupying lesions. ETV is still effective in two-thirds of the patients with previous infections or intraventricular bleeding. Patients who have previously undergone shunting and who have occlusive hydrocephalus should undergo ETV at the time of shunt failure, with immediate ligation or removal of the shunt device. In selected cases of distorted anatomy or impaired visual conditions, stereotactic guidance is helpful.
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To investigate changes in the cerebrospinal fluid flow in patients with cervical spondylosis using cine phase-contrast magnetic resonance (MR) imaging. ⋯ Cine phase-contrast MR imaging allows quantitative and noninvasive assessment of changes in cerebrospinal fluid flow in patients with cervical spondylosis.
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Dural sinus thrombosis can lead to intracranial venous hypertension and can be complicated by intracranial hemorrhage. We present a case report of a patient who underwent endovascular recanalization and stenting of a thrombosed occipital sinus. ⋯ This is the first report of mechanical recanalization, balloon angioplasty, and stent deployment in the occipital sinus to provide sustained venous outflow for the treatment of venous hypertension with retrograde cortical venous drainage in a patient with dural pansinus thrombosis refractory to anticoagulant therapy.
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We present the second report in the literature on the use of low-flow hypothermic cardiopulmonary bypass to aide in the surgical resection of a large intraparenchymal arteriovenous fistula. ⋯ The use of low-flow hypothermic circulatory bypass can facilitate the surgical extirpation of certain large intraparenchymal arteriovenous fistulas.