World Neurosurg
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Bilateral brachial plexus injury after MiraDry® procedure for axillary hyperhidrosis: a case report.
Multiple treatments are available for primary axillary hyperhidrosis including noninvasive, microwave-based thermal treatments designed to destroy sweat glands in the axilla. Often these procedures involve local anesthetic injection to the axilla, followed by placement of the microwave emitter onto the skin and applying the heat treatment to varying depths of the subcutaneous tissues. ⋯ In thin patients undergoing treatment of primary axillary hyperhidrosis, consideration should be given to the distal brachial plexus, which may be at risk of damage with high-powered microwave-based therapy.
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Endoscopic skull base surgery has evolved over the last several decades due to technological advances and operative techniques. Several innovations that are not yet mainstream may have significant impact on the future of endoscopic skull base surgery. ⋯ Several technologies are under current investigation with the hope to improve future outcomes in endoscopic skull base surgery. Additional research and evolution are necessary and will require intense scrutiny before becoming standard of care.
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The aim of this study is to characterize the use and associated costs of maximal nonoperative therapy (MNT) received within 2-years before anterior cervical discectomy and fusion (ACDF) surgery in patients with symptomatic cervical stenosis. ⋯ Opioids are the most frequently prescribed and most used therapy in the preoperative period for cervical stenosis. Further studies and improved guidelines are necessary to determine which patients may benefit from ACDF earlier in the course of nonoperative therapies.
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To evaluate the outcomes of bypass surgery for adult moyamoya and compare different surgical modalities by performing a comprehensive meta-analysis of relevant studies. ⋯ The bypass treatment was superior to conservative treatment in preventing recurrent stroke in adult patients with moyamoya, especially in those with a hemorrhagic onset. Direct bypass is associated with better revascularization results compared with indirect bypass.
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The introduction of operative microscopes (OMs) is the most important revolution in modern microneurosurgery, as a result of the implementation of lighting and magnification of the surgical field and of the capability to dissect the microneurovascular structures. Recently, the advent of video telescopic intraoperative microscopes or exoscopes (EX) has enlarged these perspectives in neurosurgery. ⋯ The EX has been emerging as an alternative to the OM for performing many cranial, spinal, and peripheral neurosurgical procedures. Despite some limitations, this new optical device presents many features that can be considered as an evolution of the OM. In future years, larger studies will confirm these preliminary impressions.