World Neurosurg
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Recently, in modern neurosurgery, a tendency toward low-traumatic surgical approaches has become clear. To provide a minimal degree of injury to the brain tissue, we have offered microsurgical approaches through a burr hole. ⋯ Burr hole microsurgery provides the ability to perform successful surgery on patients with the most diverse intracranial pathological features through a smaller opening than that used for keyhole surgery.
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Neurosurgical diseases have a devastating impact on society. It is estimated that approximately 14 million essential neurosurgical cases develop worldwide annually, of which more than 80% arise in low- and middle-income countries. Neurosurgical cadaveric dissection remains largely unexploited as a learning tool for the training of surgeons in developing countries, often because of the assumed high costs. ⋯ Our study demonstrates the feasibility of establishing a neurosurgical cadaver dissection laboratory for training and research purposes even in presence of limited resources. The introduction of cost-effective guidelines and targeted funding could represent an added value to target the unmet neurosurgical disease need by promoting development of local neurosurgical expertise with the aim of providing health coverage for the treatment of common neurosurgical pathologies in developing countries.
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Glioblastomas (GBMs) are primary brain tumors that are very difficult to treat. Magnetic resonance imaging (MRI) is the reference tool for diagnosis, postoperative control, and follow-up of GBM. The MRI tumor contrast enhancement part serves as a target for surgery. However, there are controversial data about the influence of pre- and postoperative tumor volumetric MRI parameters on overall survival (OS). ⋯ The volume of MRI contrast-enhancing GBM remnants after surgery, automatically measured by the software, was a significant predictor for early postoperative progression and death.
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Different treatment options have been proposed for aneurysmal bone cysts (ABCs) with sclerotherapy favored as primary treatment and surgery remaining the mainstay of treatment in case of compression of neural structures. Recurrent spinal ABCs are burdened by increased risk of spinal deformity and instability, further complicating the management of these cases. ⋯ Percutaneous sclerotherapy with hydroxyapatite cement proved to be highly effective and safe in the treatment of spinal ABC, though surgery remains mandatory in case of spinal cord compression. The main advantage of sclerotherapy with hydroxyapatite cement seems to be the capacity to regenerate bone with normal radiologic features.
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Neurorrhaphy with interpositional graft is a practical technique to achieve facial reanimation when the continuity of the facial nerve is interrupted and a large gap between the proximal and distal stump exists. The aim of this study was to report long-term outcomes of neurorrhaphy for facial reanimation with interpositional graft. The roles of some variable factors in the outcome of neurorrhaphy with interpositional graft were also evaluated and compared. ⋯ Early neurorrhaphy with interpositional graft (≤1 year) for facial reanimation resulted in better final facial nerve function outcomes compared with a delayed procedure.