Neurosurgery
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The accurate position of the ventricular catheter inside the frontal horn of the lateral ventricle is essential to prevent proximal failure in shunt surgery. For optimal placement, endoscopic- and image-guided techniques are available. ⋯ The new tool allows safe and quick placement of ventricular catheters. The adjustment of the tool to the planned trajectory is performed before catheter insertion and allows optimal concentration on the insertion procedure and the fingertip feeling for the penetrated tissue.
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To assess patients' perspective of combined awake craniotomy and intraoperative magnetic resonance imaging (MRI) in a prospective study. ⋯ Although the combination of awake craniotomy and intraoperative MRI is demanding, it was both tolerable and reasonable for the patients. Our data confirm that intraoperative MRI appears to have no additional significant impact on the subjective patient perception, although it does prolong the procedure.
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Adult scoliosis is a condition with increasing prevalence and medical and socioeconomic importance. Surgery is fraught with a significant complication rate in an elderly multimorbid patient population. ⋯ Instrumented correction of adult deformity was significantly facilitated by iCT navigation, eliminating radiation exposure to the surgeon. Intraoperative biplanar CT scout views including pelvis and shoulders allow comprehensive assessment of multiplanar deformity correction. Fusion rates obtained with less invasive access equal those of conventional open technique.
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Case Reports
Intraoperative use of indocyanine green fluorescence videography for resection of a spinal cord hemangioblastoma.
Indocyanine green (ICG) fluorescence videography has been recently applied to the neurosurgical field, mostly in the management of cerebral aneurysms, but has had limited description in the subspecialty of spine or oncological neurosurgery. We describe a novel application of this previously defined surgical tool to assist in the resection of a residual spinal cord hemangioblastoma. ⋯ The adjuvant use of ICG videography is a useful surgical tool that permits greater visualization of the complete extent of the lesion, particularly in managing recurrent or residual lesions obscured by adhesions.
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Case Reports
Demonstration of intraluminal thrombus in the carotid artery by optical coherence tomography: technical case report.
Intraluminal thrombus in the carotid artery is often misdiagnosed because clinical imaging, such as angiography and duplex ultrasonography, fails to accurately identify it. Recently, it was reported that optical coherence tomography (OCT), a new imaging modality, can visualize intravascular thrombus in the coronary artery. ⋯ OCT may provide useful information for diagnosis of an intraluminal thrombus in the carotid artery, which is important for the appropriate selection of therapeutic strategy.