World Neurosurg
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Intra-arterial tissue plasminogen activator (IA-tPA) has been widely used in conjunction with mechanical thrombectomy (MT) or as rescue therapy. Data on the safety of IA-tPA as a rescue therapy are scarce. ⋯ IA-tPA administration during MT was not associated with increased risk of hemorrhage in selected patients with incomplete recanalization after thrombectomy.
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Essential Neurosurgical Workforce Needed to Address Neurotrauma in Low- and Middle-Income Countries.
Among all trauma-related injuries globally, traumatic brain injury (TBI) and traumatic spine injury (TSI) account for the largest proportion of cases. Where previously data was lacking, recent efforts have been initiated to better quantify the extent of neurotrauma in low- and middle-income countries (LMICs). This information is vital to understand the current neurosurgical deficit so that resources and efforts can be focused on where they are needed most. The purpose of this study is to determine the minimum number of neurosurgeons to address the neurotrauma demand in LMICs and evaluate current evidence to support facility needs so that policy-based recommendations can be made to prioritize development initiatives to scale up neurosurgical services. ⋯ The development of neurotrauma systems is essential to address the large burden of neurotrauma in LMICs. The minimum requirements for neurosurgical workforce is 1 neurotrauma surgeon per 212,000 people.
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Treatment of symptomatic intracranial cysts remains a controversial issue. We present a risk/benefit profile of a minimally invasive, not yet described, stereotactic internal shunt implantation technique. The provided data might serve as a reference against which other treatment modalities could be compared. ⋯ The described stereotactic internal shunt implantation technique is safe and can be successfully applied for treatment of cystic formations in any location in the brain.
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Ischemic symptoms caused by traumatic vertebral artery dissection after cervical maneuvers are treated medically and surgically. This is a report of the infrequently documented occipital to vertebral artery bypass to stop the transient ischemic attacks following traumatic vertebral artery dissection. ⋯ A bypass from the occipital artery to the atlas loop of the vertebral artery is an effective procedure for traumatic extracranial vertebral artery dissection with ischemic symptoms.
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To investigate construction of an aneurysm on a curved vascular segment of a carotid siphon model for testing endovascular devices. ⋯ The carotid siphon model in vivo can simulate well the geometry of the human carotid siphon segment and can be used to test endovascular devices for interventions.