World Neurosurg
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Keeping the operating field clean and visible is an important technique in neurosurgery. Continuous irrigation-suction (IS) of the surgical field is currently often done using devices available that are expensive and demand technical proficiency. We report a simple method of continuous IS using a widely available central venous catheter and a controlled suction cannula. ⋯ The proposed IS system could be surgeon friendly, easily manageable, yet cost-effective and efficient.
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The basic necessities for surgical procedures are illumination, exposure, and magnification. These have undergone transformation in par with technology. One of the recent developments is the compact magnifying exoscope system. In this report, we describe the application of this system for surgical operations and discuss its advantages and pitfalls. ⋯ The magnifying exoscope is an effective and nonbulky tool for surgical procedures. In visualization around the corners, the exoscope has better potential than a microscope. With technical and technologic modifications, the exoscope might become the next generation in illumination, visualization, exposure, and magnification for high-precision surgical procedures.
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Case Reports
Ultrasonography monitoring with Superb Microvascular Imaging technique in brain tumor surgery.
Neuronavigation based on preoperative magnetic resonance imaging has been developed as a useful tool to improve visibility of the surgical site in the operative field. Ultrasonography (US) monitoring has also been used as a reliable imaging technique, providing real-time information during neurosurgical operations. We combined the latest innovative imaging technique for detecting very low-flow components, Superb Microvascular Imaging (SMI), with US monitoring during brain tumor surgery. ⋯ We combined SMI technique with US monitoring during brain tumor surgery and observed healthy and tumor vessels. Further research is important for the development of a more precise and reliable neurosurgery.
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Tandem occlusion resulting in acute ischemic stroke is associated with high morbidity and mortality and a poor response to thrombolytic therapy. The use of endovascular strategies for tandem stroke cases results in an improved outcome for this subgroup of patients. We present 2 cases with a pattern of tandem occlusion consisting of proximal obstruction at the origin of the common carotid artery (CCA) with concomitant intracranial occlusion treated by endovascular techniques. ⋯ An anterograde transfemoral approach should be considered in cases of tandem occlusion of the proximal CCA and middle cerebral artery.
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Case Reports
Bilateral sub-axial rotational vertebral artery occlusion in a setting of a prior cervical construct.
Rotational vertebral artery occlusion, or bow hunter's syndrome, most commonly affects the C1-2 level because of its importance in regulating rotational movement. ⋯ A brief literature review and treatment options are discussed for this unusual presentation of a rare clinical entity.