World Neurosurg
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A therapeutic dilemma exists when patients with symptomatic carotid stenosis and concomitant heparin-induced thrombocytopenia (HIT) are advised to urgently undergo carotid endarterectomy (CEA) with heparin therapy. ⋯ We now recommend systemic intravenous and local argatroban irrigation to prevent thromboembolic complications in CEA cases with HIT and renal insufficiency. Bivalirudin for both systemic intravenous use and local irrigation may be safer in patients without renal insufficiency because of its shorter half-life.
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The microsurgical anatomy of the temporal region has been well described. However, there is a paucity of information about the transventricular endoscopic anatomy of the mesial temporal lobe, and little is known about endoscopic approaches to this region. In this report, we describe the technique of endoscopic amygdalohippocampectomy (AH). The endoscopic anatomy of the mesial temporal region both before and after AH is shown. ⋯ We studied the transventricular endoscopic anatomy of the mesial temporal region and described a technique for safe endoscopic AH. The advantages and potential risks of endoscopic AH are discussed, along with suggestions for minimizing complications. We believe that knowledge of the endoscopic anatomy of the mesial temporal lobe will be useful for endoscopic AH and the removal of other lesions in this region.
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Biography Historical Article
Portrait of a life journey dedicated to neurosurgery.