World Neurosurg
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To retrospectively assess the surgical outcomes and complication rates following microvascular decompression (MVD) for trigeminal neuralgia, using a targeted, restricted retrosigmoid approach. ⋯ The use of a small craniectomy (<20 mm) in conjunction with a restricted retrosigmoid approach, inferolateral cerebellar retraction, and maintenance of the vestibular nerve arachnoid may minimize complications and optimize surgical outcomes associated with microvascular decompression for trigeminal neuralgia.
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Our goal is to indicate the importance of combining intraoperative tractography with motor-evoked potential (MEP) monitoring for glioma surgery in motor eloquent areas. ⋯ We found that intraoperative tractography demonstrated the location of the CST more accurately than preoperative tractography. The results of the linear regression between distance and stimulation intensity were informative for guiding approaches to tumor remnants without impinging on the CST. The combination of intraoperative tractography and MEP monitoring can enhance the quality of surgery for gliomas in motor eloquent areas.
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Comparative Study
Canadian health care and neurosurgery: the good, the bad and the ugly.
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The lower cranial nerves must be identified to avoid iatrogenic injury during skull base and high cervical approaches. Prompt recognition of these structures using basic landmarks could reduce surgical time and morbidity. ⋯ Comprehensible landmarks can be defined to help expose the lower cranial nerves to avoid injury to this complex region.