World Neurosurg
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Despite holding soft tissue away from high-speed drills during surgery, tissue can unexpectedly wrap around the drill shaft. We performed experiments to examine what precipitates such mishaps. ⋯ The pulling force generated by revolving high-speed drill shafts may result in tissue wraparound even when soft tissue is held away from the shaft.
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To investigate the use of lateral access surgery among surgeons from the Asia-Pacific region to determine equipoise for areas of contentious use. ⋯ Lateral access surgery is seeing greater use in the Asia-Pacific region, especially in upper middle- to high-income countries, whereas keenness of surgeons who practice in lower middle- to low-income countries can be improved by more training, resources, and reasonable cost. A high percentage of surgeons do not consider indirect decompression for spinal stenosis. There was no consensus on the order of levels in multiple level reconstruction for deformity.
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Cerebrospinal fluid tap test is a common procedure to predict the efficacy of ventriculoperitoneal shunt for idiopathic normal pressure hydrocephalus. Objective tests after cerebrospinal fluid tap test are used to establish the surgical indication, but subjective improvements may also be important in selection of surgical candidates. The aim of this study was to evaluate surgical outcomes of patients with ventriculoperitoneal shunt for idiopathic normal pressure hydrocephalus, comparing patients showing objective improvement with patients improving only on subjective assessments. ⋯ Surgical outcomes after ventriculoperitoneal shunt were similar between the 2 groups, with a more favorable trend in terms of symptom improvement for subjective responders. Subjective assessment seems to be an important factor to consider in preoperative evaluation.
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Dural arteriovenous fistulas (DAVFs) in the falx cerebri are rare. This study presents a case of DAVF in the frontal falx cerebri that was successfully resected using a purely endoscopic keyhole microsurgical technique. ⋯ Supported by sufficient preoperative evaluation and meticulous manipulation,a purely endoscopic minimally invasive resection is feasible and safe for DAVF, with the advantages of close observation and panoramic view.