Neurosurgery
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The incidence of traumatic craniocervical artery dissection varies in published trauma series. ⋯ Whole-body trauma computed tomography with an adapted scanning protocol for the craniocervical vessels is a fast, safe, and feasible method for detecting vascular injuries. It allows prompt further treatment if necessary. Computed tomography angiography could be a part of a broad screening protocol for craniocervical vessels in documented injuries of the head and neck and in trauma mechanisms influencing the craniocervical region as well.
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Incomplete coil occlusion is associated with increased risk of aneurysm recurrence. We hypothesize that intracranial stents can cause flow remodeling, which promotes further occlusion of an incompletely coiled aneurysm. ⋯ Stent-assisted coiling causes progression of occlusion, possibly by a flow remodeling effect. The odds of progression of occlusion of stent-coiled aneurysms were 18.5 times that of nonstented aneurysms.
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In cases of large and giant vestibular schwannomas (VS), the visualization of the internal auditory canal (IAC) opening is difficult or impossible. ⋯ The Tübingen line is an easy, consistent, and safe method to locate the projection of the IAC along the posterior surface of the temporal bone.
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Spinal cord stimulation is an established technology for management of chronic low back and leg pain when other surgical options have failed or are not feasible. Precise placement of the paddle-style electrode relative to the patient's distribution of pain can be difficult because of anatomic variation and the inherent limitations of electrode design. ⋯ We believe that this technique is a novel and effective method for accurately steering an epidural electrode for dorsal column stimulation for management of chronic pain.