World Neurosurg
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Comparative Study
Comparison of microscopic and endoscopic approaches to the cerebellopontine angle.
To examine the efficacy of the endoscope as an adjunct to the operating microscope in defining the surgical anatomy of the cerebellopontine angle (CPA). ⋯ The combination of endoscopic and microsurgical techniques aids in achieving optimal exposure in CPA surgery.
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To identify deficiencies leading to readmissions to the University of Florida Neurosurgery Service by using the Institute for Healthcare Improvement STate Action on Avoidable Rehospitalizations Readmissions diagnostic tool and to report the opinions of patients, their families, and health care providers. ⋯ Systematic patterns and common themes associated with patient readmissions were identified for a neurosurgical service. These findings are now being used to implement changes in discharge planning.
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Suprasellar meningiomas have been resected via various open cranial approaches. During the past 2 decades, the endoscopic endonasal approach has been shown to be an option in selected patients. We wished to examine the learning curve for parameters such as extent of resection, visual outcome, and complications. ⋯ Once the learning curve is overcome, surgeons performing endonasal endoscopic resection of suprasellar meningiomas can achieve high rates of GTR with low complication rates in well-selected cases.
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There is increasing literature supporting the importance in triaging patients to teaching hospitals for complex surgical procedures. This study analyzes the effect of teaching hospital status on outcome of endovascular coiling and microsurgical clipping of ruptured and unruptured intracranial aneurysms using the Nationwide Inpatient Sample database. ⋯ Our results suggest that the teaching status of a hospital is an independent factor for favorable outcome in the treatment of ruptured aneurysms. The difference in in-hospital death is accentuated in patients who underwent microsurgical clipping.
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Arteriovenous malformations (AVMs) of the superior vermis, superomedian cerebellum, and tectum are uncommon lesions. Various routes have enabled accessing the precentral cerebellar fissure and the posterior incisural space. ⋯ The OITT is a valuable approach for specific superior vermian, superomedian cerebellar, and tectal AVMs. Detailed assessment of angiographic features may however preclude its safety as a unique treatment plan, and complementary or alternative therapeutic options should be considered.