World Neurosurg
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Endoscopic endonasal surgery has proved to offer a practical route to treat suprasellar lesions, including tumors and vascular pathologies. Understanding the different configurations of the anterior cerebral communicating artery (ACoA) complex (ACoA-C) is crucial to properly navigate the suprachiasmatic space and decrease any vascular injury while approaching this region through an endonasal approach. ⋯ A considerable amount of variation of the ACoA-C can be found through an endoscopic endonasal transplanum-transtubercular approach. These configurations determine the feasibility of lamina terminalis exposure and the complexity of reaching the ACoA. Assessment of ACoA morphology and its adjacent structures is crucial while approaching the suprachiasmatic through a transnasal corridor.
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Review
Surgical Excision of Cirsoid Aneurysm of the Scalp: Case Series and Review of the Literature.
Cirsoid aneurysms, also known as arteriovenous malformations (AVMs), of the scalp are relatively rare lesions. They may be found incidentally or with symptoms such as an enlarging pulsatile mass, headache, or bleeding. ⋯ Preoperative embolization reduces vascularity and helps in easy identification as well as complete excision of cirsoid aneurysms during surgery. However, surgical excision alone of cirsoid aneurysms also results in excellent outcomes.
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Meta Analysis
An Algorithmic Approach to the Reconstruction of Esophageal/Hypopharyngeal Injuries after Anterior Cervical Spinal Fusion.
Anterior cervical disk fusion (ACDF) is a common surgical approach for the treatment of cervical spine pathology. Esophageal perforations, though uncommon, are a devastating complication of this surgery. The objective of this paper is to assess the success of different treatment approaches for the management of esophageal/pharyngeal injury after ACDF. ⋯ Pharyngoesophageal injuries, albeit rare, are a serious and often complex complication after ACDF procedures. We propose a detailed algorithmic approach to guide decision making if faced with this clinical challenge. The huge variability in how these patients are treated emphasizes the potential utility of future multiinstitutional studies.
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Stroke represents one of the major causes of death and long-term disability worldwide and, even when new treatment strategies have been identified, there is a need of quality clinical practice guidelines (CPGs) to guide and improve acute stroke care. We aim to describe the characteristics and assess the quality of CPGs in endovascular treatment for acute ischemic stroke due to anterior-circulation large-vessel occlusion. ⋯ The quality of the CPGs varied widely, which issues around the identification and assessment of the evidence used to reach recommendations. Despite this, the recommendations regarding the use of thrombectomy were similar across the CPGs. Readers need to carefully assess the methodologic rigor of CPGs before applying them to their clinical practice.