World Neurosurg
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The number of endovascular treatment procedures performed for cerebral aneurysms has markedly increased. However, little is known about the annual effective radiation dose to medical staff in neurointervention fields. We performed a retrospective observational study to investigate the real-time radiation dose to surgeons, nurses, anesthesiologists, and radiologic technologists during endovascular treatment of intracranial aneurysms. ⋯ We confirmed the differences in the amount of radiation exposure for different roles. An additional lead screen, which provided more effective protection on the operator side, was proved effective for attenuating radiation exposure during endovascular treatment. All personnel involved in the hybrid operating room were exposed to acceptable effective doses.
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The minimally invasive microvascular decompression (MVD) for trigeminal neuralgia is technically a more challenging operation compared with the standard retrosigmoidal approach. Endoscopic assistance could help to widen the field of view of the microscope during MVD. An extended view around the cisternal segment of the trigeminal nerve can be achieved only with the targeted dissection of the arachnoid membranes. The goal of our study was to analyze the three-dimensional organization of these membranes around the trigeminal nerve. ⋯ Knowledge of the described anatomy of the arachnoid membranes around the trigeminal nerve is essential to safely perform an MVD.
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Autism spectrum disorder represents a set of developmental disorders characterized by lack of social interaction and verbal and nonverbal communication in the first 3 years of life. It is also associated with several comorbidities, including epilepsy, aggression, self-mutilating behavior, and obsessive-compulsive behavior. In some cases, obsessive-compulsive disorder (OCD) develops. The nucleus accumbens (NAc) plays a key role in reward circuitry and is involved in the control of OCD and aggression. ⋯ This case report illustrated the role of the NAc in OCD and aggression in an autistic patient. We discussed the role of the NAc as a target to explain the outcome of this case.
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We report a retrospective analysis of hardware failure in patients requiring instrumentation for spinal metastasis. ⋯ The rate of hardware failure in this cohort was 13.8%, although operative revision rate was 3.4%. Spinal instrumentation in patients with poor preoperative functional status or multiple myeloma may be more likely to develop instrumentation failure.
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To assess the sensitivity and specificity of arteriovenous malformation (AVM) nidal component identification and quantification using an unsupervised machine learning algorithm and to evaluate the association between intervening nidal brain parenchyma and radiation-induced changes (RICs) after stereotactic radiosurgery. ⋯ The automated segmentation algorithm was able to achieve classification of the AVM nidus components with relative accuracy. Greater proportions of intervening nidal brain parenchyma were associated with RICs.