World Neurosurg
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Case Reports
Interval Thrombosis of Arteriovenous Malformation Draining Vein after Stereotactic Radiosurgery.
Arteriovenous malformations (AVMs) are high-pressure vascular lesions that can present formidable therapeutic challenges. One treatment option for these lesions is stereotactic radiosurgery, which may be used to provoke progressive thrombosis of the draining veins and subsequent obliteration of the AVM nidus. In this clinical image, we successfully demonstrate this therapeutic modality with the case of a 26-year-old man with a large frontal AVM, treated with stereotactic radiosurgery.
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Tethered cord syndrome is a rare and intractable disease. The aim of this study was to investigate surgical outcome of homogeneous spinal-shortening axial decompression (HSAD) for tethered cord syndrome through a minimum 3-year follow-up. ⋯ HSAD was effective and safe. The results were satisfactory with a minimum 3-year follow-up. HSAD could be an alternative surgical treatment of TCS.
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An increasing body of literature describing use of high-fidelity surgical training models is challenging long-held dogma that cadavers provide the best medium for postgraduate surgical skills training. The purpose of this study was to describe a surgical skills course comprising entirely synthetic training models developed by resident and attending neurosurgeons and to evaluate their perceptions of the overall usefulness of this course and its usefulness compared with cadaveric courses. ⋯ Resident and attending neurosurgeons subjectively believe that high-fidelity synthetic models were superior to cadavers as a surgical skills teaching platform. This study raises the question of whether cadavers should remain the gold standard for surgical skills courses. Expanded use of these teaching models and further study are warranted.
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Cerebral venous thrombosis (CVT) is a rare entity with a potentially fatal outcome. Patients who do not respond to standard medical therapy alone may benefit from endovascular treatment options. We evaluate the angiographic and clinical results of mechanical thrombectomy in patients with severe CVT. ⋯ Transvenous mechanical thrombectomy is feasible, safe, and effective, leading to a high degree of successful recanalization rate of occluded dural sinus. It may be a salvage treatment for selected patients with severe CVT refractory to standard medical treatment.
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Fat grafting has been described as an option to repair frontotemporal contour deformities (volumetric deficiency of bone and/or soft tissues) after neurosurgical/craniofacial surgical interventions. However, technical surgical descriptions have varied, with reports describing the bolus fat injection or the classical multilayer injection, but with no detailed descriptions concerning how and where the fat should be grafted. The purpose of this study was to assess the frontotemporal symmetry outcomes after a single fat-grafting procedure for postoperative frontotemporal contour deformity reconstructions using the anatomical fat-grafting approach. ⋯ Patients with frontotemporal contour deformities presented improved subjective and objective frontotemporal symmetry after an anatomical fat grafting session.