World Neurosurg
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Musculoskeletal and neural alterations secondary to chronic atlantoaxial instability are evaluated. ⋯ The experience with the case showcases wide ranged spinal consequences as a result of chronic atlantoaxial instability.
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Neurosurgery departments worldwide have been forced to restructure their training programs because of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we describe the impact of COVID-19 on neurosurgical training in Southeast Asia. ⋯ An effective national strategy to control COVID-19 is crucial to sustain neurosurgical training and to provide essential neurosurgical services. Training programs in Southeast Asia should consider developing online learning modules and setting up simulation laboratories to allow trainees to systematically acquire knowledge and develop practical skills during these challenging times.
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Case Reports
Intraosseous Arteriovenous Fistula Around the Anterior Condylar Confluence as an Occipital Bone Fracture Sequela.
Although traumatic dural arteriovenous fistula (AVF) is a rare condition, dural injury associated with skull fracture is one of the major factors for the formation of dural AVF at the skull fracture area. We report a case of de novo intraosseous AVF around the anterior condylar confluence after head injury associated with skull base fracture. ⋯ There is no previous report to our knowledge of intraosseous AVF around the anterior condylar confluence proven to appear after skull fracture. This case demonstrates that head injury associated with skull base fracture could be one etiology of dural AVF around the anterior condylar confluence.
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Review Meta Analysis
Comparison of bypass and non-bypass surgical treatments for internal carotid artery blood blister-like aneurysms: a meta-analysis of efficacy, safety and outcomes.
The optimal surgical strategy for treating internal carotid artery (ICA) blood blister-like aneurysms (BBAs) has remained unclear. Although some have preferred bypass surgery, others have favored less-demanding surgical methods. The aim of the present meta-analysis was to assess the efficacy, safety, and outcomes of bypass and non-bypass surgical methods when intended as primary treatment of ICA BBAs. ⋯ For surgeons who use both bypass and non-bypass surgical strategies, the 2 methods seemed comparable in terms of the outcomes of interest, although the bypass technique appeared superior. However, comparisons with studies reporting bypass as the uniquely preferred technique have indicated that specialization in, and preference for, the bypass procedure has been associated with more favorable outcomes.