Neurosurgery
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Comparative Study
Examining concussion rates and return to play in high school football players wearing newer helmet technology: a three-year prospective cohort study.
The purpose of this study was to compare concussion rates and recovery times for athletes wearing newer helmet technology compared to traditional helmet design. ⋯ Recent sophisticated laboratory research has better elucidated injury biomechanics associated with concussion in professional football players. This data has led to changes in helmet design and new helmet technology, which appears to have beneficial effects in reducing the incidence of cerebral concussion in high school football players.
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Comparative Study
Comparative analysis of anterior petrosectomy and transcavernous approaches to retrosellar and upper clival basilar artery aneurysms.
To compare two techniques, transcavernous approach (TcA) and anterior petrosectomy (AP), used to manage retrosellar and upper clival basilar artery (BA) aneurysms. ⋯ From an anatomic standpoint, the TcA offers more advantages than the AP, when approaching retrosellar BA aneurysms, except for those cases in which proximal control is the principal issue and the neck of the aneurysm is located more than 6.0 mm below the floor of the sella.
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Comparative Study
Subtemporal approach to the tentorial incisura: normative morphometric data based on magnetic resonance imaging scans.
The tentorial notch can be contained within a transversal line made in front of the cerebral peduncles and another line through the posterior border of the quadrigeminal plate into the anterior, middle and posterior parts. Different approaches to the tentorial incisura have been established. The subtemporal approach represents one of those options. Since morphometrical analyses of this approach in this region have not yet been performed, the aim of the present study was to measure the surgical corridor along these borders. ⋯ Knowledge of these distances and various contours of the path is crucial to avoid brain damage during retraction or manipulation. The curvature of the floor of the middle cranial fossa is highly variable and thus determines the surgical path chosen.
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We performed a systematic microanatomical study of the occipital artery (OA) and its branches to describe the course, diameter, and branches of this vessel as well as the presence and pattern of anastomotic channels between the OA and the vertebral artery. ⋯ Detailed knowledge of the OA anatomy is helpful in choosing this vessel as a donor for extra-intracranial bypasses. More importantly, knowledge and understanding of the type and pattern of anastomoses between the OA and the vertebral artery are critical to avoid disastrous complications (i.e., posterior circulation stroke) during embolization of vascular or neoplastic processes fed by distal OA branches.
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The use of intrathecal morphine has been effective with few complications for chronic intractable pain of both benign and malignant origins. A rare but serious problem that exists is the formation of an inflammatory mass at the catheter tip of the pain pump. ⋯ This is the first such case, to our knowledge, of a bupivacaine precipitate mimicking a spinal cord tumor.