Neurosurgery
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Clinical Trial
Cerebral cavernous malformations associated with venous anomalies: surgical considerations.
Once thought to be rare entities, mixed cerebrovascular malformations with pathological features of more than one type of malformation within the same lesion are now being recognized with increasing frequency. Their identification generates several hypotheses about common pathogenesis or causation-evolution among different types of lesions and leads to controversial discussion on therapeutic strategies. ⋯ Our results are in favor of the hypothesis that the draining vein of a VM is the actual underlying abnormality of mixed vascular malformations. Causing flow disturbances and having the potential for hemorrhages, the VM seems to promote the development of new adjacent malformations. Thus, permanent cure of associated malformations might depend on the surgical treatment of the VM. We present a preliminary personal series and a thorough review of the literature.
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Intraventricular surgery requires a detailed knowledge of the microanatomy of the choroid plexus vasculature. ⋯ The data obtained on the microanatomy of the intrachoroidal vasculature may have certain neurosurgical implications.
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Clinical Trial
Microvascular retractor: a new concept of retracting and repositioning cerebral blood vessels.
In this technical note, we report our results with a newly designed retractor blade that can be directly applied for the retraction and repositioning of cerebral blood vessels and delicate neural structures. ⋯ The new retractor incorporates the existing advantages offered by flexible self-retaining retractor blades with those features that adapt to blood vessel retraction. Rather than concentrating force at one point as typical retractors do, the semicircular tip distributes the retraction force over multiple points along its circumference.
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Comparative Study
Hypothesis of the postconcussive vulnerable brain: experimental evidence of its metabolic occurrence.
We evaluated the effects of two consecutive concussive injuries on brain energy metabolism and N-acetylaspartate (NAA) to investigate how the temporal interval between traumatic events influences overall injury severity. ⋯ The biochemical modification severity in double TBI is dependent on the interval between traumatic events, which demonstrates the metabolic state of the vulnerable brain after mild TBI. These data support the hypothesis of the application of proton magnetic resonance spectroscopy to measure NAA as a possible tool to monitor the full recovery of brain metabolic functions in the clinical setting, particularly in sports medicine.