World Neurosurg
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Entrapped temporal horn syndrome secondary to obstructive neoplastic lesions is most frequently treated by surgical excision of the offending lesion. Here we describe an alternate approach involving temporal horn to prepontine cistern shunting followed by radiosurgery of the offending lesion. ⋯ Trapped temporal horn syndrome secondary to obstructive neoplastic lesions can be treated by internal shunting followed by radiosurgery.
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Review Historical Article
"Through the looking glass": optical physics, issues, and the evolution of neuroendoscopy.
Although the concept of endoscopy has existed for centuries, a practical, working neuroendoscopic system did not emerge until last century, as a result of numerous contributions and refinements in optical technology, illumination sources, and instrumentation. Modern neuroendoscopy would not be a flourishing field, as it is today, without the dedication, innovation, and implementation of emerging technology by key contributors including Maximilian Nitze, Walter Dandy, and Harold Hopkins. ⋯ In this review, the history of neuroendoscopy, key players who envisioned how the inner workings of the human body could be visualized "through the looking glass," and current state and future potential for neuroendoscopic surgery are discussed. Future directions of neuroendoscopic surgery will likely be guided by further miniaturization in camera and optical technology, innovations in surgical instrumentation design, the introduction of robotics, multi-port minimally invasive surgery, and an enhanced ability to perform bimanual microdissection.
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Adequate training based on cadaveric dissection is essential to acquire a practical knowledge of surgical anatomy and microsurgical/endoscopic dissection techniques. Endoscopic procedures for the treatment of pathologies of the skull base are becoming increasingly common. The endoscopic training curve for tool handling and a detailed knowledge of the topographic anatomy of the skull base require intensive training on cadavers before approaching living patients, which is why cadaver laboratory experience should be mandatory for every resident and surgeon preparing to use microsurgical and endoscopic techniques. We describe the basic principles of the philosophy of anatomic dissection and the equipment necessary to set up an endoscopic cadaver laboratory.
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To summarize the current knowledge of the mechanisms leading to rebleeding and the prevention of rebleeding after subarachnoid hemorrhage (SAH). ⋯ Further studies are warranted before the exact mechanisms leading to rebleeding are established and the optimal preventive measures are made available. At the present time, antifibrinolytic therapy remains the only realistic protective measure during the initial 6 hours after SAH during which the rebleeding rate is highest.