Neurosurgery
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To describe a modification of the pterional approach (PT), the minipterional craniotomy (MPT), and compare the anatomic exposure provided by these two approaches. ⋯ The MPT craniotomy provides comparable surgical exposure to that offered by the PT. The advantages of the MPT include reduction of tissue trauma and bony removal, a decrease in surgical time, and improved cosmetic outcomes.
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The superficial venous system of the posterior neck (suboccipital venous plexus) is a potential source of complications from bleeding and air embolism. Because there is little information available about this in the literature, an anatomic study of the superficial posterior neck venous system and a morphometric analysis of the mastoid emissary vein (MEV) complex were undertaken. Both surgical and endovascular implications were considered. ⋯ The suboccipital venous plexus in the posterior neck region may be very large. The size of the veins in the plexus varies, but the drainage pattern remains consistent. The plexus is a potential source of intense bleeding and air embolism during posterior fossa approaches. The risks are greatest for lateral surgical approaches, as a result of the anatomic position of the venous system. The described measurements can be used to approach the MEV in endovascular procedures that involve the sigmoid sinus.
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The pattern of triceps innervation is complex and, as yet, has not been fully elucidated. The purposes of this study were 1) to clarify the anatomy of the triceps motor branches, and 2) to evaluate their possible uses as a donor or receiver for nerve transfer. ⋯ Each of the triceps' motor branches might be used as a donor for transfer. The triceps long head motor branch should be used preferentially when the intention is to establish triceps reinnervation.
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To describe a novel technique for single stent reconstruction of wide-necked aneurysms arising from the circle of Willis. ⋯ Stenting across the circle of Willis represents a novel adjuvant technique to support the coiling of selected wide-necked intracranial aneurysms. This technique is particularly useful for wide-necked terminal aneurysms that incorporate both branches of a bifurcation in a configuration unfavorable for Y-stent reconstruction.
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Case Reports
Fluorescence of non-neoplastic, magnetic resonance imaging-enhancing tissue by 5-aminolevulinic acid: case report.
It has been established that fluorescence-guided resection using 5-aminolevulinic acid is useful in glioma surgery. In this study, we describe three cases in which even perinecrotic tissue could be recognized as fluorescence positive. ⋯ Both malignant tumors and the perinecrotic area in radiation necrosis or neurodegenerative disease can be labeled as fluorescence positive using 5-aminolevulinic acid.