World Neurosurg
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Intracranial bypass is technically challenging and difficult to learn owing to its relative rarity and complexity. Although multiple training models for intracranial bypass exist, a detailed depiction of the use and fidelity of cadaveric specimens for bypass training is lacking in the literature. This study describes use of preserved cadaveric specimens as a practical training model for performance of multiple intracranial bypasses and discusses the surgical setup for a cadaveric bypass laboratory. ⋯ The cadaveric specimen trainee model is a relatively simple yet high-fidelity approach for learning intracranial bypass.
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To evaluate the safety and effectiveness of partial vertebrae resection laterally through intervertebral space to harvest supplemental autograft bone for anterior cervical discectomy and fusion (ACDF). ⋯ Partial vertebrae resection laterally through the intervertebral space was a safe and effective method to harvest supplemental autograft bone for the ACDF.
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Traditional wound closure techniques include skin sutures and metal clips. Cyanoacrylate has good neovascularization, epithelialization, and antimicrobial activity properties and a fast application procedure. This study presents our long-term experience. ⋯ With additional research, we can confirm that cyanoacrylate glue may be a valid and useful alternative to traditional techniques for wound closure in brain surgery, carrying several advantages. However, a randomized controlled trial with a large number of patients is warranted to confirm our findings.
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The etiology of Chiari I malformation (CMI) has not been fully elucidated. Therefore, we performed a genetic study of a Turkish family in which 3 sisters had a diagnosis of CMI with or without syringomyelia. ⋯ This family with 3 sisters having CMI suggested a possible autosomal recessive single-gene etiology. Cases of familial CMI are unusual but important to study because they could reveal the specific genes involved in posterior fossa/foramen magnum structure and function and provide insights into the cause of sporadic cases.
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Recent reports have described that endovascular treatment of coil embolization of opththalmic artery (OphA) aneurysms has a relative risk of visual disruption caused by thromboembolic infarction of the central retinal artery (CRA), especially the OphA when it originates within the body of the aneurysm. Patent microthrombus in the OphA might also cause retinal infarction that affects visual acuity. We describe stent-assisted coil embolization of an OphA aneurysm complicated with a severe visual disturbance, although normal flow was scrupulously maintained in the OphA during the procedure. The visual disturbance was recovered by early treatment. ⋯ Despite good anterograde flow in the OphA during aneurysm embolization, the procedural risk of a visual disturbance due to thromboembolic complications of CRA occlusion cannot be avoided. Anterograde flow in the OphA and retinochoroidal blush should be monitored by repeated angiography during coil embolization to prevent vision loss. Should vision be lost, a rapid response including ocular massage and intraarterial fibrinolysis is required for recovery.