World Neurosurg
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Excision of coil mass during clipping of recurrent or residual aneurysms after prior endovascular coiling is challenging. We evaluated the use of the carbon dioxide laser for safe and effective removal of coils during aneurysm surgery. Two cases are presented. ⋯ Excision of coil mass is required while treating recurrent and/or residual intracranial aneurysms that were previously treated by endovascular technique. The use of carbon dioxide laser assistance while retrieving these coils is safe and effective.
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The optimal treatment of recurrent primary central nervous system lymphoma (PCNSL) has not yet been determined. We report a patient with recurrent PCNSL who has been successfully treated with stereotactic brachytherapy (SBT) with iodine-125 seeds plus temozolomide (TMZ). ⋯ To our knowledge, this is the first case of recurrent PCNSL successfully treated with SBT plus TMZ. Further randomized studies are needed to confirm the therapeutic impact of this new method.
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In recent decades endoscopic techniques have been increasingly used in neurosurgery as they may offer a valuable close-up view of the working area through a minimally invasive surgical corridor. Herein, we present an inexpensive and efficient endoscopic surgical model using a borescope, which was used for a "modified pure endoscopic approach" to the pineal region. ⋯ Our proposed "borescopic" surgical model may represent an inexpensive and efficient alternative to conventional endoscopic techniques and could be used for training purposes, as well as even for clinical procedures, after a proper validation, particularly in economically challenging environments.
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In India, men outnumber women in neurosurgery by a wide margin. At the graduation party of our woman colleague, we recalled the experiences of the past few years. It led to a transforming experience for the authors, who have hitherto only held the "mens' perspective." ⋯ Conversation itself is one of the greatest forces for changing the situation and how this conversation can be taken forward to transform a "culture of discrimination" to a "culture of acceptance."
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Variations and additions to the endoscopic endonasal exposure have been proposed around a modular strategy. These extensions are often necessary to provide additional working space and reduce conflict between the instruments and the endoscope. Resection of endonasal structures, which affects negatively the sinonasal quality of life, is thus undertaken not only to obtain tumor exposure but also to improve the maneuverability of the instruments. ⋯ We propose a technical modification that allows the surgeons to benefit from the advantages of a bimanual technique while still holding the endoscope. In our opinion, this technique may improve dynamic understanding of the anatomy and surgical efficiency and reduce the footprint of the surgery.