Neurosurgery
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Review Case Reports
Optimal surgical approaches for Rathke cleft cyst with consideration of endocrine function.
Surgical indications for Rathke cleft cyst are not clear. ⋯ Minimal incision with radical removal of cyst content is reasonable to prevent the development of endocrine disturbances and other complications. Individualized risks and benefits must be assessed before a decision is reached regarding surgery and surgical method. Patients with recurrent Rathke cleft cyst require careful follow-up with special attention rather than a hasty operation.
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Surgical clipping with complete occlusion of the aneurysm and preservation of parent, branching, and perforating vessels remains the most definitive treatment for intracranial aneurysms. ⋯ Endoscopic enhancement of the visual field provided by the endoscope before, during, and after microsurgical aneurysm occlusion may be a safe and effective application to increase the quality of treatment. Although unexpected findings concerning completeness of aneurysm occlusion and compromise of involved vessels could be diminished by endoscopic assessment, total prevention was not accomplished.
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Traditionally, the medical management of concussion has involved close observation and physical and cognitive rest. Most postconcussive symptoms resolve spontaneously and require only conservative treatment. However, some patients have prolonged recoveries and may benefit from treatment with medications. ⋯ The evidence supporting the various pharmacologic treatments in concussion is equivocal. The choice of which medication to use for a patient depends on the symptom characteristics, and each decision should be made on an individual-case basis. There is a need for well-designed trials investigating the efficacy of various medical therapies.
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Size and morphological features are associated with intracranial aneurysm (IA) rupture. The cellular mechanisms of IA development and rupture are poorly known. ⋯ The signaling pathway profile (apoptosis, cell proliferation, stress signaling) differs between ruptured and unruptured IAs and is associated with IA geometry. Our results increase the knowledge of IA development and wall degeneration.
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Historical Article
Invention of the N-localizer for stereotactic neurosurgery and its use in the Brown-Roberts-Wells stereotactic frame.
The N-localizer, which facilitates computed tomography-guided stereotactic surgery, was invented in the late 1970s by a medical student who built a prototype stereotactic frame to test the concept. Initial experiments using the prototype frame were soon followed by surgery in humans using the Brown-Roberts-Wells stereotactic frame.