World Neurosurg
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Resection of brain arteriovenous malformation (AVM) is challenging, particularly if the feeder arteries and draining vein are not directly visible on the surface. Indocyanine green video angiography can assist in detection of the connecting point of the draining vein with the superficial vein and can thus localize the cortical entry point for AVM resection. Here, we present a case of a 27-year-old man with headache. ⋯ Postsurgical video-ICG showed normalized flow in the superficial vein supporting the complete resection of AVM. ICG is potentially helpful for detecting the cortical entry point of a deep draining vein with a sprawled superficial vein. ICG should be used as an adjunct to better understand the microvascular anatomy that may aid decision making during AVM surgery.
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Review Meta Analysis Comparative Study
Operative complications with and without image-guidance: A systematic review and meta-analysis of the Ommaya reservoir literature.
The use of image guidance (IG) in neurosurgery is ubiquitous, even though evidence from patient outcome data has remained limited to smaller, mostly observational, studies. Ommaya reservoir insertion (ORI) has been available as a treatment option for targeted intraventricular pharmacotherapy since the 1960s, far preceding the modern neuronavigation era. We conducted a systematic review and meta-analysis investigating the impact of IG on surgical outcome from ORI. ⋯ This study offers a historical context on the evolution of the practice of ORI and comprises the largest observational analysis of operative outcomes providing objective support for the use of IG in neurosurgery.
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Review Case Reports
Bullough's lesion: an unexpected diagnosis after the resection of a slowly growing osseous-like retroauricular bump. Case report and review of the literature.
We describe the case of a 33-year-old woman with a history of over 15 years of a slow growing firm osseous-like right retroauricular mass. Surgical resection was easily performed using a sharp technique, because of a clear cleavage plane. ⋯ Clinical differential diagnosis must be done with osteoma, periosteal chondroma, and other fibro-osseous lesions such as fibrodysplasia and ossifying fibroma. Because of the paucity of data, the natural history of this lesion is unknown and serial clinical and radiological follow-up is advised.
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Although Africa accounts for 15% of the global volume of neurosurgical disease, African hospitals and health care networks have access to <1% of the neurosurgeon community. Health care and neurosurgical care are particularly scarce in sub-Saharan Africa due to long periods of imperialism, civil war, poverty, and famines that have plagued the area. ⋯ Partnerships between developing countries and sub-Saharan African countries may be the starting point in supplying neurosurgical specialists to the countries in need.