World Neurosurg
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Lenticulostriate middle cerebral artery (MCA) aneurysms are rare and often involve perforating vessels, making endovascular treatment difficult. When projecting superiorly, aneurysm rupture can likely cause intraparenchymal hemorrhage in basal ganglia. Consequently, surgical clip ligation requires control not to aggressively elevate the frontal lobe to avoid intraoperative injury. ⋯ Postoperative angiogram confirmed complete aneurysm ligation. The patient clinically did well and was discharged home on postoperative day 2. Our video demonstrates safe and effective surgical treatment of a rare aneurysm2 through a small LSO craniotomy approach (Video 1).
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Biopsy of pineal region neoplasms is frequently accomplished by way of endoscopic transventricular access or using an image-guided, computer-assisted stereotactic approach. ⋯ This method appears to be a safe alternative to stereotactic biopsy using other trajectories and provides adequate tissue for definitive diagnosis.
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Giant pituitary adenomas are considered a surgical challenge. Their invasiveness, irregular growth, and extensions make this surgery critical. Because of this reason, the radical resection rate is low in such pathology. ⋯ He had no hypopituitarism and diabetes insipidus after the surgery. Cerebrospinal fluid leak was not observed. Unfortunately, oculomotor palsy did not improve after surgery (Video 1).