World Neurosurg
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Case Reports
Spontaneous vertebral arteriovenous fistula mimicking brachial radiculo-plexopathy: A case report.
Vertebral arteriovenous fistulas (VAVFs) are uncommon high-flow communications between a vertebral artery and surrounding venous plexus that occur spontaneously or secondary to trauma. ⋯ This is a rare case of VAVF manifesting as a brachial radiculoplexopathy. Although rare, VAVF may be considered as a potential cause in patients presenting with similar symptoms.
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Treatment of complex middle cerebral artery (MCA) aneurysms are challenging; however, an appropriate surgical strategy can ensure favorable outcomes. Notably, a protective bypass strategy is essential to treat complex aneurysms and involves the creation of a bypass channel distal to the aneurysm before repairing it. A protective bypass enables the surgeon to establish adequate distal blood flow during the approach to the aneurysm, as well as during additional revascularization. ⋯ Hence continuous follow-up is essential. The next surgical strategy should be reconsidered according to the situation if the recurrence is occurred. This surgical video shows the surgical strategy and stepwise procedure to treat complex aneurysms and will be useful to vascular neurosurgeons to devise a surgical approach utilizing a "protective bypass strategy."
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In 2014, the Young Neurosurgeons Committee under the American Association of Neurological Surgeons (AANS) began allowing medical schools to create AANS Medical Student Chapters. The aim of this study was to assess the impact of these chapters on participation in organized neurosurgery, research productivity, and residency match success. ⋯ Since their inception, AANS Medical Student Chapters have demonstrated substantial research productivity and involvement in organized neurosurgery. Furthermore, there is an association between higher chapter activity, manifested by publications and annual meeting attendance, and increased residency match success.
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Case Reports
Microsurgery "Under the Eaves" using ORBEYE: A Case of dAVF of the Anterior Cranial Fossa.
One of the merits of exoscopes, including ORBEYE, is that they are superior to a microscope in terms of ergonomic features. We report a case of dural arteriovenous fistula (dAVF) that was cured by direct surgery using the ergonomic advantages of ORBEYE. ⋯ ORBEYE facilitates ergonomic microsurgery, even under the eaves, with the angle of the operative visual axis approximately horizontal using gravity.
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Intraoperative manipulation of the craniocervical junction with the Cervical Management Base Unit (CMBU) has been used as an adjunct for achieving optimal anatomic alignment during instrumented fusion procedures in a variety of disease settings. Here, we present our experience using the CMBU as a supplement to achieving a successful reduction and fixation of a reducible craniocervical subluxation with associated basilar impression/medullary compression in the setting of Grisel syndrome. ⋯ Intraoperative manipulation of the craniocervical junction using the CMBU, when implemented under fluoroscopy and neuromonitoring, can safely facilitate an enduring anatomic correction of craniocervical deformity in the setting of Grisel syndrome. The dynamic utility of the CMBU for translation of the head and neck obviated the need to apply forces directly to hardware-bone interfaces, and its utility may extend to craniocervical disorders of other etiologies, especially those of a reducible nature and in the setting of poor bone quality and joint laxity.