World Neurosurg
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Nasopharyngeal carcinoma (NPC) is a common malignant tumor of the head and neck, and is associated with high recurrence and low survival rates; however, distant brain metastasis from NPC is rare. ⋯ Despite the poor prognosis, salvage SRS was performed for these rare brain metastases from NPC.
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To delineate the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of patients with cervical spondylotic radiculopathy by diffusion tensor imaging and fiber bundle tracing. ⋯ Fiber tractography is capable of delineating microstructural changes of cervical nerve roots and cervical spondylotic radiculopathy exhibits significant changes in FA and ADC values.
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This is new research about the technology for navigating a catheter that is eccentric or tangentially angled to the long axis of a carotid artery stent. In our clinical practice, we found resistance when the 8-French guiding catheter crossed the balloon, even when it was partially expanded. Therefore we intended to improve the operating procedure by using a smaller balloon with a diameter of 2 mm. The smaller balloon can navigate the guiding catheter to reaccess the angled junction with minimal resistance after it is fully expanded. ⋯ Using the small balloon bridge technique to navigate the guiding catheter is a safer, simpler, and more effective operation for carotid interventional therapy. Furthermore, it might also be applied to other endovascular treatments that require guiding catheters for intervention.
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Rootlets of the lower cranial nerves create a web that limits microsurgical maneuverability in the cerebellomedullary cistern (CMC). The vagoaccessory triangle (VAT) and 2 triangles within it were defined to identify surgical routes to aneurysms of the posterior inferior cerebellar artery (PICA). Dividing the VAT into 2 triangles (suprahypoglossal [SHT] and infrahypoglossal [IHT]), although elegant, oversimplifies CMC anatomy. The triangle formed by the superior and inferior hypoglossal rootlets (hypoglossal-hypoglossal triangle [HHT]) needs consideration as well. ⋯ Based on this study, VAT should be divided into 3 triangles, not 2. Splayed rootlets of cranial nerve XII and multiple outlet foramina create an important space different from the previously recognized SHT and IHT. These triangles provide corridors to vascular pathologies. V4 subsegments may be approximated from imaging studies and may help with preoperative planning.
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An awake throughout (AT) approach for awake craniotomy is mostly under utilized. The purpose of this study was to review the efficacy of the technique at our tertiary care center. The primary objective was to identify the incidence of perioperative complications. The secondary objective was to review the patients' satisfaction, satisfaction of surgical team, length of stay (LOS) in special care unit (SCU), and overall LOS in the hospital. ⋯ An AT approach might be very useful in resource-limited setups because of the low incidence of complications, the use of resources, and significant surgeon and patient satisfaction.