World Neurosurg
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Standard electrostimulation cortical mapping includes application of electrical current to the explored areas through an electrode and marking of functional zones by means of paper tags with different symbols. This approach has several disadvantages. First, the electrode is moved randomly. It leads to overlooking of some zones, which causes mapping deficiency, and restimulation of others, which can trigger epileptic seizures. Second, the tags easily shift and close the marked structures. We describe a new simple device that provides precise cortical mapping without indicated problems and the technique to apply it. ⋯ Our case illustrates that the proposed invention can be successfully used in neurosurgical operations for precise electrostimulation mapping of the brain cortex.
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Endovascular coiling is generally considered as an effective treatment option for ruptured intracranial aneurysms. Increasing operator experience and quality of tools determined an improvement of endovascular cerebral aneurysms' treatment. However, procedure-related complications still occur. The purpose of this study is to report a series of rescue stenting procedures with the Neuroform Atlas (NA) open-cell stent, for intraprocedural complications during coil embolization in patients with ruptured intracranial aneurysms. ⋯ The open-cell NA stent represents a rescue option for coil protrusion during endovascular treatment of ruptured intracranial aneurysms allowing regular restoration of blood flow and minimizing thromboembolic events.
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Stereoscopic video recordings of operative microscopy during neuroanatomic dissections are an important component of surgical training and research in well-financed medical schools and teaching hospitals. However, the high cost of the latest operative microscopes with integrated video recording equipment can be a limiting factor in their worldwide use. The aim of the present work is to provide a simple low-cost 3-dimensional (3D) stereoscopic operative microscope recording system that can be used even in economically and resource-limited locations. This is achieved by using readily available smartphones, smartphone accessories, and computer software. ⋯ The 3D video system demonstrated herein can be implemented on any type of operative microscope, including older units for which commercial stereo recording systems are not available. The system and method presented herein can be readily and affordably implemented in low-budget environments for clinical training and research.
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Subarachnoid hemorrhage (SAH) can be associated with a degree of resulting brain damage and subsequent reorganization of the central nervous system. The aim of this study was to evaluate complication rates and clinical outcome in patients with a previous SAH who were treated for a recurrent or an additional, initially unruptured aneurysm. ⋯ Treatment of recurrent or additional aneurysms in patients with a previous SAH can be performed with acceptable complication rates and morbidity by either surgical or endovascular means.
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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.