World Neurosurg
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To report the use of neuroelectrophysiologic monitoring to alter the course in aneurysm surgery to minimize postoperative infarction and bypass-related adverse events. ⋯ Intraoperative physiologic monitoring is a complementary method to preoperative BTO to evaluate the window of safe occlusion with high reliability.
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Review Meta Analysis Comparative Study
Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of craniopharyngiomas.
Craniopharyngiomas have traditionally represented a challenge for open transcranial or transsphenoidal microscopic neurosurgery because of their anatomical location and proximity to vital neurovascular structures. The extended endoscopic endonasal transsphenoidal approach has been more recently developed as a potentially surgically aggressive, yet minimal access, alternative. To gain a more comprehensive assessment of the benefits and limitations of the various approaches to resection of craniopharyngiomas, we performed a systematic review of the available published reports after endoscope-assisted endonasal approaches and compared their results with transsphenoidal purely microscope-based or transcranial microscope-based techniques. ⋯ The endoscopic endonasal approach is a safe and effective alternative for the treatment of certain craniopharyngiomas. Larger lesions with more lateral extension may be more suitable for an open approach, and further follow-up is needed to assess the long-term efficacy of this minimal access approach.
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The association between intracranial aneurysms and arteriovenous malformations (AVMs) or dural arteriovenous fistulas (DAVFs) has been well documented, and the changes in cerebral blood flow dynamics were thought to be one of the major causes. There has not been a report on intracranial aneurysms associated with multiple DAVFs and AVMs in the same patient. ⋯ To our knowledge, this is the first report of a very rare case with a unique combination of cerebrovascular pathologies including multiple aneurysms, DAVFs, and 1 high-grade AVM. Analyzing the hemodynamic relationships of these concurrent lesions is essential to determine the hemorrhage risk of each lesion and the order of priority in management. Flow-related aneurysms with irregular morphology require early, aggressive treatment.
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Historical Article
Endovascular neurosurgery in Europe and in Italy: what is in the future?
The cerebrovascular discipline has undergone dramatic changes in recent years. This has been made possible by the work of pioneers in the fields of neurosurgery and neuroradiology. ⋯ To remain at the forefront of evaluating, caring for, and treating patients with cerebrovascular disease, vascular neurosurgery must evolve toward a specialty, mastering the knife as well as the catheter. We think it is time for European neurosurgeons to start training residents in endovascular neurosurgery in the same way we train neurosurgeons in every other neurosurgical discipline. • Peer-Review Report.
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Case Reports
Use of multimedia messaging system (MMS) by junior doctors for scan image transmission in neurosurgery.
Multimedia Messaging Service (MMS) is used by neurosurgical residents to transmit scan images to the attending neurosurgeon in conjunction with telephone consultation. This service has been well received by the attending neurosurgeons, who felt that after viewing scan images on their phones, they felt increased confidence in clinical decision making and that it reduced the need for recall to the hospital. ⋯ It is feasible and safe for junior doctors to utilize MMS to transmit computed tomographic images to a neurosurgeon while making an urgent referral. The images selected are representative of the disease pathology and facilitate clinical decision making.