Neurosurgery
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Significant hemorrhage may occur from the cerebral venous sinuses during the dural separation from the bone flap, particularly in elderly patients. It is important to achieve an urgent hemostatic control. ⋯ We report our experience with a new hemostasis technique to manage bleeding from iatrogenic lacerations of cerebral venous sinuses.
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Although numerous studies have focused on the efficacy of deep brain stimulation (DBS) for movement disorders, less is known about surgical adverse events, especially over longer time intervals. ⋯ These data provide low incidences for adverse events in a large series of DBS surgeries for movement disorders at up to 10 years follow-up. Accurate estimates of adverse events will better inform patients and caregivers about the potential risks and benefits of surgery and provide normative data for process improvement.
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Proximal lesions of the sciatic nerve are often difficult to diagnose and to treat properly. In particular, if there are posttraumatic or postoperative alterations, imaging might not identify the level and location of lesion. Due to the sciatic nerve anatomy, the same is true for clinical and electrophysiological evaluation with a risk of delayed surgery and, thus, unsuccessful surgery. Therefore, in some unclear cases, surgical exploration of the whole sciatic nerve and its divisions could be the only means to determine the correct diagnosis and allow prompt treatment to produce the best clinical outcome. ⋯ The endoscopically assisted single- to multiportal sciatic exploration technique provides excellent visualization that enables nerve inspection, lesion detection, and decompression, and obviates the need for more extensive approaches in cases of unclear sciatic nerve pathology. By adding several ports, whole-length exploration of the sciatic from the notch to fibular head level is feasible.