World Neurosurg
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Quantitative comparison of minimally invasive and standard cranial approaches remains a methodologic challenge. The aim of this study was to apply a new digital, navigation-based method to quantify multiple parameters of the pterional, supraorbital, lateral supraorbital and mini-pterional approaches and to describe a target-specific maneuverability score. ⋯ The combination of a navigation-based measurement method with custom software (GTxEyesII) provides a powerful tool for visualization and quantification of surgical approaches. Compared with standard pterional craniotomy, alternative keyhole craniotomies offer comparable deep exposure with smaller working volumes and relatively high maneuverability for specific targets.
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Os odontoideum is an uncommon abnormality of the craniovertebral junction where the tip of the odontoid process lacks continuity with the body of C2. The clinical presentation is variable, but severe neurologic impairment can result. ⋯ To our knowledge, there are no cadaveric reports in the literature regarding an os odontoideum. Such a case allows a rare window into the anatomy and relationships of this pathologic structure.
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The purpose of this study was to examine the safety and efficacy of target embolization of aneurysms associated with ruptured brain arteriovenous malformations (BAVMs). ⋯ Target embolization of aneurysms associated with ruptured BAVMs could significantly decrease postoperative rehemorrhage without increasing complications.
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Case Reports
Intraoperative visualization of subependymal arteries at the atrium supplying the descending motor pathway.
We previously disclosed that damage to the subependymal arteries (SEAs) caused by coagulation of the choroid plexus at the atrium can result in infarction within the lateral posterior choroidal artery territory, followed by hemiparesis. The present study describes the intraoperative anatomical findings of the SEAs and choroid plexus at the atrium, which were verified only by a few cadaveric studies. ⋯ Manipulations to the inner side of the choroid plexus at the transition from the atrium to the body of lateral ventricle can damage the SEAs. Not only coagulation of the SEAs themselves, but also coagulation of choroid plexus itself may reduce the blood flow in the SEAs, resulting in ischemic complications at descending motor pathway.