World Neurosurg
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Removing the posterior longitudinal ligament in cervical corpectomy is a controversial issue. It is unclear whether the risks are counterbalanced by clinical benefits. Another unexplored topic is whether the width of the corpectomy affects outcome. ⋯ Removing the posterior longitudinal ligament in cervical corpectomy may produce a better outcome, particularly when associated with more posterior bone wall removal in the corpectomy.
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Subdural hematoma, without any radiographic evidence of subarachnoid hemorrhage, is a rare presentation of a ruptured intracranial aneurysm. Even more rare is the occurrence of a pure subdural hematoma caused by a ruptured cortical saccular aneurysm. We report the eighth case of pure subdural hematoma secondary to a ruptured nonmycotic cortical berry aneurysm. ⋯ In the context of a presentation of spontaneous subdural hematoma, intracerebral aneurysm rupture should be considered as a possible etiology. Prompt vascular imaging with careful evaluation of the entire cerebral vasculature, including the cortical vessels, should be considered.
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Transnasal endoscopic approaches to the clivus have been established recently. Comparative analyses with classic lateral approaches are limited. In this study, we compared transnasal endoscopic and lateral approaches to the clivus, quantifying the exposure and working volume of each approach in the anatomy laboratory. ⋯ This quantitative anatomic study shows that endoscopic transnasal approaches to the clivus provide a larger working volume and wider exposure of the clivus compared with lateral approaches.
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CyberKnife stereotactic radiosurgery (SRS) for trigeminal neuralgia (TGN) administers nonisometric, conformational high-dose radiation to the trigeminal nerve with risk of subsequent hypoesthesia. ⋯ These outcomes demonstrate that a lower maximum brainstem dose can provide excellent pain control without affecting facial numbness. Longer nerves may achieve better long-term outcomes and help optimize individual plans.
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Comparative Study Clinical Trial
Another Endovascular Therapy Strategy for Acute Tandem Occlusion: Protect-Expand-Aspiration-Revascularization-Stent (PEARS) Technique.
Initial stenotic occlusion of the internal carotid artery with intracranial artery occlusion in acute ischemic stroke is associated with high morbidity and can benefit from endovascular therapy. However, the optimal endovascular strategy is unclear. This study aimed to evaluate the feasibility of the "half" anterograde approach and clinical outcome of treated patients. Revascularization validity of the 2 "half" anterograde approach with (Protect-Expand-Aspiration-Revascularization-Stent [PEARS] technique) or without (plain technique) using an embolic prevention device and aspiration was also compared. ⋯ The half anterograde approach technique is feasible and safe for treating tandem occlusion. Furthermore, the PEARS technique is associated with a shorter reperfusion time and less embolic events than the plain technique, and should be recommended in tandem occlusion.