World Neurosurg
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Delayed cerebral ischemia (DCI) can cause significant morbidity and mortality in patients suffering from aneurysmal subarachnoid hemorrhage (SAH). Because arterial stiffness has been correlated with vascular risk factors, we evaluated whether the ankle-brachial index (ABI), the ratio of the ankle and brachial systolic blood pressures, can predict DCI. ⋯ In this small single-center study, lower ABI values were strongly associated with SAH-induced DCI, which may provide a tool for managing DCI in aneurysmal SAH.
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Pituitary tumors account for approximately 15% of primary intracranial neoplasms and often are diagnosed incidentally. Common sellar lesions are pituitary adenomas, craniopharyngiomas, and Rathke cleft cysts. Currently endoscopic transsphenoidal approaches are largely used, and many centers also use 3-dimensional (3D) technology, although additional results of long-term follow-up are still being accumulated. ⋯ The use of an endoscopic endonasal approach with 3D technology provides several advantages relating to patient length of stay, rate of complications, postoperative recovery, and novice surgeons' training. Advantages of 3D endoscopy and long-term follow-up still need further elucidation.
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Case Reports
Bilateral pallidotomy for cervical dystonia after failed selective peripheral denervation.
We investigated the utility of pallidotomy for cervical dystonia after failed selective peripheral denervation. ⋯ Pallidotomy represents a feasible and effective treatment for cervical dystonia refractory to selective peripheral denervation without hardware-related complications.
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The orbitofrontal (or frontobasal) arteries (OFAs) are the medial (MOFA) and lateral (LOFA) orbitofrontal artery, branches of the anterior and middle cerebral artery, respectively. They supply the orbitofrontal cortex. The purpose of this microscopic cadaveric study was the detailed and precise anatomic identification of the OFAs along their course. ⋯ The present study provides a detailed description of the OFAs' microsurgical anatomy and can help neurosurgeons to easily identify, manipulate, and preserve these vessels during surgery.
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Occipital artery pseudoaneurysms are extremely rare pathologies that manifest after traumatic injury; only 11 cases have been reported in the literature. Because of their low incidence and vague symptoms, the initial diagnosis can be difficult. However, for correctly diagnosed occipital artery pseudoaneurysms, many successful treatment modalities exist. ⋯ Our case highlights the fact that occipital swelling, a significant initial sign of pseudoaneurysm development, can be delayed. Therefore, occipital artery pseudoaneurysms cannot be ruled out of the differential diagnosis based on time course alone. Surgical resection is a quick and effective method for relief of severe pain resulting from occipital artery pseudoaneurysms. Although they are rare entities, occipital artery pseudoaneurysms must be considered in the differential diagnosis of cases of pulsatile mass lesions in the posterior scalp.