Turk Neurosurg
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Unexpected bleeding from the dural sinus can sometimes occur when performing a dural opening during microvascular decompression. We conducted dural opening safely by performing indocyanine green (ICG) videoangiography before making a dural incision. We introduce two specific cases in which surgery was performed to treat a trigeminal neuralgia. ⋯ Using a microscope equipped with fluorescent filters, real-time flow assessment of the underlying veins was done. ICG videoangiography allowed for a clear confirmation of the margins of the dural sinus as well as the vascular structures at the surface of the cerebellum, which were clearly seen through the dura mater. Performing ICG videoangiography prior to dural opening makes it possible to safely perform dural opening.
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Review Meta Analysis
Effects of Intensive Blood Pressure Lowering on Intracerebral Hemorrhage Outcomes: A Meta-Analysis of Randomized Controlled Trials.
Elevation of blood pressure (BP) is common after intracerebral hemorrhage (ICH). Early BP treatment may be beneficial after ICH, but the effect of intensive BP lowering on ICH outcomes is not known and no systematic review or meta-analysis was published regarding this issue. ⋯ Acute lowering of SBP to 140 mmHg is probably beneficial for functional outcome in patients with ICH, but the evidence is still insufficient. Further large multicenter studies are required to enhance the evidence to guide the BP lowering target following ICH.
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Cases of failed back and spine surgery have increased significantly recently, which leads to patient hesitation in deciding about whether to be operated on. In this article, we present a survey investigating refusal reasons for spinal surgery, and we emphasize the effect of failed back surgery. ⋯ Spinal surgery is a preferred subspecialty of neurosurgery. However, patients' discontent with spinal surgery has been rising gradually in recent years. An accurate indication and proper surgical technique is essential for increasing satisfaction with spinal surgery. Minimally invasive interventions must be considered if necessary. The postoperative expectations of the physician and the patient must also be carefully defined.
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Transforaminal approach in lumbar disc herniations: transforaminal microdiscectomy (TFMD) technique.
The endoscopic foraminal approach in foraminal, lateral and far-lateral disc hernias, is a contemporary minimal invasive approach. This study was performed to show that the approach is possible with using the microscope without an endoscope, and even intervention on the discs within the spinal canal is possible by having access through the foramen. ⋯ Transforaminal microdiscectomy is a method that can be performed in any clinic with standard neurosurgical instruments. It does not require additional equipment or a high amount of investment. Application of transforaminal inter-body fusion is possible when required.
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Spongostan™ is a sterile, water-insoluble, porcine gelatin absorbable sponge, which is widely used as a hemostatic material. The aim of this study is to test the anti-fibrotic capacity of Spongostan™, using a craniotomy model in an experimental rabbit model. ⋯ We conclude that an appropriately placed subdural Spongostan™ over cerebral tissue may prevent postoperative surgical adhesions after neurosurgical operations.