World Neurosurg
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Sellar arachnoid cysts are a rare occurrence but may impinge on vital parasellar anatomy and thus are often symptomatic. The etiology of sellar arachnoid cysts is contentious, fueled by heterogeneity in cyst wall structure and contents between cases. The "ball-valve" mechanism is 1 of 2 predominant theories describing their formation, which contends that an aperture in the diaphragm allows cerebrospinal fluid to enter the cyst, propelled by pulsatile flow, but its egress is obscured by the pituitary during the ebb of the pressure wave. ⋯ Intraoperative video evidence during arachnoid cyst fenestration supports the "ball-valve" theory of sellar arachnoid cyst development.
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Comparative Study
Comparison of Impact Factor, Eigenfactor Metrics, and SCImago Journal Rank Indicator and h-index for Neurosurgical and Spinal Surgical Journals.
In academic specialties such as neurosurgery, bibliometrics are often used to guide readers, academic institutes, and researchers to make objective assessment of journals. Recently, new indices have been developed to overcome the shortcomings of the widely used Impact Factor. The objective of our study was to investigate the correlations among 6 of the commonly used bibliometric indices (Impact Factor, SCImago Journal indicator, SCOPUS h-index, Google h-index, Eigenfactor, Article Influence Score) in neurosurgical and spinal surgical journals. ⋯ Despite the different mathematical basis among the citation-based bibliometric indices studied, they have strong correlations in ranking neurosurgical journals. This study provides evidence that the newer indices may be used interchangeably with the Impact Factor in this context, and they may, theoretically, mitigate some the shortcomings of the Impact Factor.
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The literature on surgical management of atypical hangman's fracture (AHF) is sparse. The aim of this study was to describe an individual surgical strategy using a lag screw-rod technique for treatment of unstable AHF based on different fracture patterns. ⋯ Using individual surgical strategies based on different fracture patterns, the posterior C2-C3 lag screw-rod technique may be an effective and reliable option for unstable AHF.
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Posterior fossa tumor surgery is associated with a significant risk of complications, and the complications are typically more frequent compared with similar supratentorial surgeries. This study aimed to evaluate 1) the extent of resection and neurologic outcomes and 2) perioperative complications with use of minimally invasive approaches for intra-axial posterior fossa tumors from our case series. ⋯ We demonstrated the possible efficacy of a minimally invasive approach with the use of tubular retractors and exoscopic visualization for resecting posterior fossa intra-axial tumors with relatively high efficacy and low morbidity.
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Using proper surgical technique, schwannomas can be resected safely, with a low recurrence rate and high likelihood of improvement in symptomatology. There are multiple peritumoral tissue layers, and finding the correct plane is critical to safe tumor enucleation. The contents of the pseudocapsule tissue surrounding a schwannoma are not well described, and the consequences of resecting or leaving pseudocapsules are unknown. ⋯ The pseudocapsule surrounding a schwannoma occasionally contained nerve tissue and blood vessels. While a microscopic focus of tumor was often found in this tissue layer, recurrence is exceedingly rare and did not occur in this case series. The risk of undue pseudocapsule dissection likely outweighs any negligible benefit from microscopic cytoreduction.