World Neurosurg
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A 66-year-old woman had presented with a 3-month history of left trigeminal neuralgia. She had undergone successful microvascular decompression for right-sided trigeminal neuralgia 8 years previously. ⋯ We have provided preoperative and intraoperative images illustrating nicely the adapted postoperative change in venous outflow causing contralateral compression of the trigeminal nerve. Consecutive treatment effects should be carefully considered when offering and performing surgical microvascular decompression.
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Cervical radiculopathy is a common cervical spine condition. There is a paucity of literature discussing the effect of partial pediculotomy and partial vertebrotomy for posterior endoscopic cervical foraminotomy (PPPV PECF) on cervical radiculopathy. We investigated the radiologic and clinical outcomes of this approach. ⋯ PPPV PECF is a safe route of decompression of cervical spine with good clinical and radiologic outcome.
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Lesions arising at the ventral thalamopeduncular junction are difficult to resect. In addition to being relatively inaccessible, these lesions are located in one of the most sensitive areas of the brain. A critical question is whether new approaches could be developed to allow surgeons to adequately resect these lesions with reasonable outcomes. In the present report, we describe our approach to resect lesions in this region of the brain using an eyebrow craniotomy approach with a trajectory through the supracarotid triangle. ⋯ Lesions arising at the ventral thalamopeduncular junction can be adequately resected with reasonable outcomes using an eyebrow, supracarotid triangle approach. This operative technique establishes another potential operative corridor by which neurosurgeons can resect lesions arising within this relatively inaccessible part of the brain.
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Deep brain stimulation of the ventral intermediate nucleus (VIM) or caudal zona incerta (cZI) is effective for refractory essential tremor (ET). To refine stereotactic planning for lead placement, we developed a unique individualized anatomy-based planning protocol that targets both the VIM and the cZI in patients with ET. ⋯ Individualized anatomy-based VIM-cZI targeting is feasible and safe and is associated with favorable tremor outcomes.
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A carotid web (CW), an atypical fibromuscular dysplasia, is rare and may cause ischemic stroke. It is challenging to recognize a CW promptly and treat it accordingly. We report a case of an initially misdiagnosed CW. ⋯ Clinicians should be aware of CW as a potential cause of ischemic stroke. Head and neck computed tomography angiography is a reliable imaging method to detect CWs.