World Neurosurg
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Case Reports
Purely Endoscopic Retrosigmoid Approach for Excision of a Large Multicystic Hypoglossal Schwannoma.
Hypoglossal schwannomas are rare tumors that account for 1%-7% of all nonvestibular intracranial schwannomas. They commonly affect middle-aged females.1 They can be completely intracranial (type A), intracranial/extracranial (type B), or completely extracranial (type C).2 Presenting symptoms include hypoglossal nerve dysfunction, additional lower cranial neuropathies and, rarely, increased intracranial pressure. Patients with the rare extracranial tumors most commonly present with an asymptomatic mass in the neck or submandibular region.3 Treatment options include observation in small asymptomatic tumors and surgical excision in large tumors with mass effect. ⋯ A purely endoscopic retrosigmoid approach was performed for excision of the lesion. A 4K rigid endoscope offers a highly illuminated and extremely detailed views of the tumor and the anatomic structures within the surgical field, adding greatly to the safety of surgery. Furthermore, the panoramic view and large depth of focus of the endoscope result in greater ease of orientation within the surgical field with significant reduction of the number of times the viewing angle needs to be changed during the procedure.
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Traumatic brain injury (TBI) is an essential and common health problem worldwide. Levosimendan is an inotropic and vasodilator drug used to treat heart failure. Moreover, it exerts pleiotropic effects and, thus, protective effects on many organs. The present study aimed to investigate the effect of levosimendan on necrosis, apoptosis, and reactive oxygen species in rats with TBI. ⋯ Our results indicated that levosimendan may exert a neuroprotective effect by reducing necrosis in TBI and that levosimendan does not affect apoptosis and antioxidant levels in TBI. Comprehensive studies are needed to elucidate the effect of levosimendan on TBI fully.
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Stroke is a leading cause of disability and mortality worldwide. Related research, although already providing significant insights regarding the underlying pathophysiology and potential treatment strategies, has been far from conclusive. Stroke models have been proved of extreme significance for laboratories around the world. In the present report, we have described in detail the most popular to date focal stroke model, the transient intraluminal filament middle cerebral artery occlusion (tifMCAO) model in rats. This model reliably mimics stroke in humans and also approximates endovascular thrombectomy. ⋯ The tifMCAO stroke model in rats is the most often used experimental model of focal ischemia because of its clinical relevance. We revisited the procedure and divided it, for instructional purposes, into 15 consecutive and distinct steps.