World Neurosurg
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Clinical Trial
Superficial temporal artery to middle cerebral artery bypass via a minimized approach: operative nuances and problem solving aspects.
The minimized approach for superficial temporal to middle cerebral artery (STA-MCA) bypass surgery is frequently associated with unfamiliar situations and technical problems. ⋯ The surgical applications, operative techniques, problem-solving aspects, and development of new instruments are described. Potentially, these suggestions may enhance the surgical confidence and convenience to perform STA-MCA bypass surgery with a minimized approach.
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The ventriculoscopic approach has been considered to be more safe and effective in the treatment of hydrocephalus, arachnoid cysts and intraventricular lesions in neurosurgery. We found that intraoperative bleeding-related complications have the greatest impact on ventriculoscopic surgery. Until now, few studies fully discussed this complication. ⋯ Intraoperative hemorrhage in ventriculoscopic surgery should be paid more attention. Generally, a skilled neurosurgeon can address hemorrhage with a low complication rate. Consequently, the ventriculoscopic approach is safe and effective in the treatment of specified brain ventricular disease.
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Comparative Study
How does brainstem involvement affect prognosis in patients with limited brain metastases? Results of a matched-cohort analysis.
Although brainstem metastases are thought to portend an inferior prognosis compared to non-brainstem brain metastases, there is limited evidence to support this claim, particularly in the modern radiosurgical era. ⋯ The survival of patients with brain metastases is inferior after a metastatic lesion develops within the brainstem, despite favorable local control with brainstem SRS. The brainstem location should be considered a negative prognostic factor for survival after SRS, and it could result from the eloquence of this location. Future research could identify the clinically life-limiting component of brainstem metastases.
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Tarlov cyst is an abnormal expansion of the spinal nerve sleeve, and it communicates with the subarachnoid cavity via a perineural fistula. This study presents our experience of a balloon-assisted fistula sealing procedure in treating Tarlov cyst. ⋯ The balloon-assisted fistula sealing procedure is safe and effective for Tarlov cyst, especially for the single cyst. It is a good complement to the cyst wall imbricating procedure.
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Case Reports
Abducens nerve avulsion and facial nerve palsy following temporal bone fracture- a rare concomitance of injuries.
Avulsion of the abducens nerve in the setting of geniculate ganglion injury after temporal bone fracture is unreported previously. We discuss clinical assessment and management of a patient with traumatic avulsion of cranial nerve (CN) VI in the setting of an ipsilateral CN VII injury after temporal bone fracture and call attention to this unusual injury. ⋯ This case illustrates 2 subtle findings on imaging with potential therapeutic implications, notably the role of surgical intervention for facial nerve palsy.