World Neurosurg
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Atlas fracture occurs in 3%-13% of all cervical spinal injuries and is often associated with other injuries. The factors associated with concomitant transverse ligament disruption and vertebral artery injury remain underexamined. ⋯ Among patients with atlas fractures, vertebral artery injury and transverse ligament disruption are associated with each other. Mechanism of injury, fracture type, and intoxication at the time of injury were associated with vertebral artery injury, and atlantodental interval and lateral mass displacement are associated with magnetic resonance imaging-confirmed injury to the transverse ligament.
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Acquisition of Basic Microsurgical Skills Using Low Cost Readily Available Models: The Orange Model.
Attainment of basic microsurgical skills in neurosurgery presents a departmental challenge worldwide. Models for teaching are either not readily available or expensive and are incompatible with a resident's busy schedule, requiring lengthy and proper setup. We present a model and a set of measurable tasks, based on a fruit (orange) that is cheap, easy to set up instantly when desired, and useful for training of basic microsurgical skills. ⋯ The orange model is an easily accessible, cheap model that enables the acquisition of basic microneurosurgical skills. In this work, we validated and defined reproducible tasks that can be scored and tracked, correlated with operator's proficiency and experience. This model can be incorporated into a resident's workflow environment and provides a platform for attainment of elementary microsurgical skills for neurosurgical residents.
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In this study, we evaluated the changes in resting-state networks (RSNs) under anesthesia in neurosurgical patients. ⋯ Different RSNs could be identified under anesthesia and used for intraoperative brain mapping and remapping during tumor resection. However, RSNs showed a significant decrease in connectivity with the continuation of anesthesia.
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Case Reports
Neurocysticercosis Superimposing Schwannoma: A Unique Combination of 2 Pathologies at Cerebellopontine Cistern.
Neurocysticercosis, a common parasitic infection in developing areas, usually exists in supratentorial parenchyma. Literature review shows few case reports published for cerebellopontine angle cysticercosis, but its coexistence with a schwannoma in the same cistern has never been seen before. This leads to confusion in preoperative diagnosis and management. ⋯ Cysticercosis should be kept as a differential diagnosis in cystic lesions of the CP angle, especially in endemic areas and even in cases showing obvious cystic schwannoma on imaging. Care should be taken to prevent spillage of cyst contents while puncturing the cyst wall for a better outcome.
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Arachnoid cysts are responsible for 1% of expansive lesions in the central nervous system. Usually, they do not cause neurologic symptoms unless they have expansion or hemorrhage. Intracystic bleeding is caused by trauma or may be spontaneous. ⋯ Despite being asymptomatic, the hematoma was determined to have significant mass effect; thus, it was evacuated by a parietal burr-hole. After 1 month, another MRI showed resolution of the frontoparietal hematoma and significant reduction in the arachnoid cyst. There are few cases described of spontaneous rupture of arachnoid cyst; beyond that, we would like to illustrate a step-by-step procedure that is not widely available as a video article.