World Neurosurg
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Quadrigeminal cistern arachnoid cysts (ACs) are usually asymptomatic, may be accidental findings during radiological evaluation, and are rare (5%-10% of all intracranial ACs). We report a case of type I quadrigeminal cistern AC managed via navigation-guided cystoventriculostomy followed by endoscopic third ventriculostomy (Video 1). A 0° rod-lens endoscope was used. ⋯ Pineal region ACs and associated hydrocephalus can be successfully treated with simple, minimally invasive endoscopic procedures. Navigation assistance may not be necessary in all cases, but it allows for safe, rapid location of the fenestration site. A minimally invasive route and attention to smaller nuances of anatomy are key to safe management of these benign conditions.
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Although several commercially available sutureless anastomotic techniques are available, they are not routinely used in neurosurgery. We performed an in vivo flow analysis of end-to-end anastomosis using a microvascular coupler device in rats. We report our first clinical use of the microvascular anastomotic coupler. ⋯ In vivo quantitative flow analysis demonstrated no flow difference between an unaltered artery and artery with end-to-end anastomosis using a microvascular coupler in rats. A 1-mm coupled anastomosis achieved a 4-fold flow increase with low-resistance venous outflow in rats, simulating increased arterial demand. The coupler was successfully used for extracranial-to-intracranial bypass in a patient.
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To investigate whether financial bias exists in hydrocephalus and vertebral augmentation literature. ⋯ Our findings suggest a positive relationship between reported conflict of interest and positive outcome in neurosurgical literature concerning cerebrospinal fluid valves.