World Neurosurg
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Identification and protection of the cochlea during anterior petrosectomy is key to prevent hearing loss. Currently, there is no optimal method to infer the position of the cochlea in relation to the Kawase quadrangle; therefore, damage to the cochlea during anterior petrosectomy remains a substantial risk. ⋯ The cochlear safety line is a reliable landmark to avoid the cochlea during the Kawase approach. When expanding the anterior petrosectomy posteriorly, the cochlear safety line can be used as a reliable landmark to prevent exposure of the cochlea, thus preventing hearing loss.
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Embolization followed by Radiosurgery for the Treatment of Brain Arteriovenous Malformations (AVMs).
Embolization has been proposed to reduce the size of the arteriovenous malformation (AVM) nidus in advance of radiosurgical treatment. Embolization followed by radiosurgery for brain AVMs, however, is controversial. ⋯ These data suggest that embolization of brain AVMs can safely and effectively reduce the treatment volume before radiosurgery. Combined therapy with embolization and radiosurgery does not appear to adversely affect rates of excellent outcome.
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Standard open surgical management of thoracolumbar infection, trauma, and tumor is associated with significant morbidity. We compared perioperative and immediate postoperative morbidity of open and mini-open thoracolumbar corpectomy techniques including direct hospital costs. ⋯ Mini-open TL corpectomy is a safe, cost-effective, clinically effective, and less morbid alternative to standard open thoracotomy surgical techniques.
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To evaluate the histopathologic effects of smoking before, during, and after pregnancy on the intervertebral disk structure of newborns in an experimental rat model. ⋯ Results of this study imply that maternal smoking before and during pregnancy and in the lactation period may have deleterious effects on the intervertebral disk of the newborn. The duration of smoking and fertility period can influence the type and severity of these effects.
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In some cases of drug-resistant focal epilepsy, noninvasive presurgical investigation may be insufficient to identify the ictal onset zone and the eloquent cortical areas. In such situations, invasive investigations are proposed using either stereotactic electroencephalography (SEEG) or subdural grid electrodes. Meta-analysis suggests that SEEG is safer than subdural grid electrodes, but insular implantation of SEEG electrodes has been thought to carry an additional risk of intraparenchymal hemorrhagic complications. Our objectives were to determine whether an insular SEEG trajectory is a risk factor for intracranial hematoma and to report the global safety of the procedure and provide some guidelines to prevent and detect complications. ⋯ SEEG is a safe procedure. Insular trajectories cannot be considered an additional risk of intracranial bleeding.