Neurosurgery
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Defining the anatomic zones for the placement of occiput-C1 transarticular screws is essential for patient safety. ⋯ Viable transarticular occiput-C1 screw placement is possible, despite variability of the anatomy of the occipital condyle.
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T1/T2 matching to differentiate tumor growth from radiation effects after stereotactic radiosurgery.
We define magnetic resonance imaging (MRI) and clinical criteria that differentiate radiation effect (RE) from tumor progression after stereotactic radiosurgery (SRS). ⋯ We found that time to progression and T1/T2 mismatch were able to differentiate tumor progression from RE in most patients. When REs are suspected, surgery may not be necessary if patients respond to conservative measures. When tumor progression is suspected, resection or repeat radiosurgery can be effective, depending on the degree of mass effect.
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Accessing intradural lesions via an extended endoscopic endonasal approach requires a relatively large bony removal over the skull base. ⋯ The Sonopet ultrasonic bone curette is a useful tool during endoscopic endonasal skull base surgery.
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Since the pioneering studies of human thalamic anatomy based on histology and binding techniques, little new work has been done to bring this knowledge into clinical practice. ⋯ It seems possible to identify the subcompartments of the thalamus by spontaneous MRI contrast, allowing a tissue architectural approach. In addition, the MRI tissue architecture matches the earlier subcompartmentalization based on cyto- and chemoarchitecture. This true 3D anatomic study of the thalamus may be useful in clinical neuroscience and neurosurgical applications.