World Neurosurg
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Case Reports
Microscopic minimally invasive keyhole technique for surgical resection of spinal dumbbell tumors.
Multiple surgical modalities have been developedl and applied for surgical excision of spinal dumbbell tumors. The microscopic minimally invasive keyhole technique has not yet been well characterized for this purpose. We report our experience with 1-stage surgical resection of both intraforaminal and extraforaminal/paraspinal components of spinal dumbbell tumors using the microsurgical keyhole technique. ⋯ The microscopic minimally invasive keyhole technique can be used successfully for resection of spinal dumbbell tumors. Further comparative studies are warranted to demonstrate the benefits of the microsurgical keyhole technique compared with traditional open procedures for surgical resection of spinal dumbbell tumors.
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A 53-year-old man was admitted to our hospital following a traffic accident. He had been riding a bicycle and was knocked down by a motorcycle, injuring the right side of his forehead. Upon arrival at our department, he was conscious and we found no cerebrospinal fluid rhinorrhea or otorrhea. ⋯ Repeat computed tomography 9 hours later showed partial absorption of the pneumocephalus, which was almost completely absorbed 4 days later. He recovered well and was discharged after 7 days. At the 1-month follow-up, the patient was well, although the reduced vision in his right eye persisted.
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Comparative Study
Outcomes after Transcranial and Endoscopic Endonasal Approach for Tuberculum Meningiomas - a retrospective Comparison.
Degree of resection and visual outcome are the main concerns in the surgical resection of tuberculum sellae meningioma (TSM). In addition to the transcranial approach (TCA), the endoscopic endonasal approach (EEA) has been used increasingly. However, the controversy regarding the optimal surgical approach is not clearly resolved. ⋯ Surgical approaches do not affect the gross total resection rates, but the locations of residual tumor or recurrence differ according to surgical approaches. EEA is superior to TCA in visual outcome. At least in pure TSMs, the trend seems to be shifting in favor of EEA, considering the huge difference in visual outcome.
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The incidence of meningioma has increased drastically recently, particularly in older adults. Surgical intervention has the potential to reduce neurologic symptoms and achieve favorable, long-term outcomes. There is considerable variability in the literature examining the relationship between age and outcomes after meningioma surgery. The objective of this study was to identify the relationship between age and postoperative complications after craniotomy for resection of meningioma. ⋯ Advanced age, particularly >80 years, is an independent predictor of morbidity and mortality in patients undergoing craniotomy for resection of meningioma. As such, it should be considered in preoperative optimization and risk stratification.
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Training of intra-axial brain tumor resection using a self-made simple device with agar and gelatin.
Self-made devices composed of agar and gelatin gel were used for resident training in intra-axial brain tumor resection. The mixture gel of agar and gelatin is retractable and can be suctioned. Hardness of the gel depends on the concentration of the solution. Therefore, by changing the concentration, it is easy to make gels of various hardness. ⋯ Our devices with "tumors" of various hardness appear to be suitable for resident training in each surgical skill. For the next step of this study, we will attempt to fabricate more practical 3-dimensional gel models for presurgical simulation.