Neurosurgery
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Comparative Study
Reduction of magnetic resonance imaging-related heating in deep brain stimulation leads using a lead management device.
To evaluate the ability of a lead management device to reduce magnetic resonance imaging (MRI)-related heating of deep brain stimulation (DBS) leads and thereby to decrease the risks of exposing patients with these implants to MRI procedures. ⋯ Small, concentric loops placed around the burr hole seem to reduce MRI-related heating for these implants. Although the mechanism is still not fully understood, a device such as that used in the present study could permit a wider range of clinical scanning sequences to be used at 1.5 and 3 T in patients with DBS implants, in addition to increasing the margin of safety for the patient.
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Case Reports Comparative Study
Transcallosal transchoroidal approach to tumors of the third ventricle.
Although the literature is rich with descriptions of the approach to the third ventricle, surgeons remain cautiously reserved. In this report, we demonstrate that the transcallosal approach can be easily performed provided that preoperative planning is adequate. Familiarity with the course of major cortical and deep draining veins grants the surgeon a wide exposure of the posterior third ventricle. We discuss the indications, surgical technique, and pitfalls to this approach while providing an accompanying video mirroring our discussion.
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Comparative Study Clinical Trial
Craniofacial resection for cranial base malignancies involving the infratemporal fossa.
Cranial base malignancies involving the infratemporal fossa have been considered unresectable. Advanced operative techniques have made tumor resection feasible in an en bloc fashion with negative histological margins, but there are limited data regarding outcome analysis in patients who have undergone resection of malignant tumors in this area. ⋯ Despite the extensive nature of many infratemporal fossa tumors, they can be resected with acceptable morbidity. Survival rates approach those of anterior cranial base malignancies without infratemporal fossa involvement.
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We identify radiographic imaging similarities found on head computed tomographic (CT) scans of patients with through-and-through gunshot wounds to the head with fatal outcomes. ⋯ We confirm that GCS score and diabetes insipidus correlated with fatal outcome. In the setting of low-velocity gunshot wounds, fatal outcome and low GCS score were associated with a tram-track sign on CT scans. Bullet passage through a particular supra-dorsum sellar transventricular zone was associated with fatal outcome.
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Comparative Study
Stereoelectroencephalography in the presurgical evaluation of focal epilepsy: a retrospective analysis of 215 procedures.
To report on indications, surgical technique, results, and morbidity of stereoelectroencephalography (SEEG) in the presurgical evaluation of patients with drug-resistant focal epilepsy. ⋯ SEEG is a useful and relatively safe tool in the evaluation of surgical candidates when noninvasive investigations fail to localize the epileptogenic zone. SEEG-based resective surgery may provide excellent results in particularly complex drug-resistant epilepsies.