World Neurosurg
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Hydrocephalus ranks among the most prevalent neurosurgical conditions worldwide, with a growing body of literature suggesting a potential association with inflammation. Employing bibliometric methods, this research visually analyzes the scholarly output on inflammation in hydrocephalus over the past 2 decades and provides a scientific framework for delineating research pathways and addressing key issues in this field. ⋯ This study will help researchers determine the mainstream research directions and latest hotspots of inflammation in hydrocephalus and provide a reference for revealing the molecular mechanism of hydrocephalus.
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Deep brain stimulation (DBS) is a well-established treatment for motor circuit disorders such as Parkinson disease, dystonia, and essential tremor, particularly when pharmacological interventions are insufficient.1-3 The increase in DBS-related publications and the growing number of patients receiving DBS highlight the acceptance and refinement of the procedure.3,4 Despite its widespread use, comprehensive anatomical knowledge of deep brain nuclei remains critical for enhancing clinical efficacy. Accurate targeting of the complex three-dimensional anatomy of the target nuclei is crucial for maximizing therapeutic effects and minimizing adverse side effects. However, existing anatomical guides often lack depth perception.5,6 We dissected specimens prepared using the Klingler method,7 proceeding sequentially from lateral to medial, medial to lateral, and superior to inferior. ⋯ Our models were evaluated via augmented reality within a real-world context, and radiological models of these nuclei generated through segmentation were analyzed. Thus, our models and videos offer a novel method for visualizing the complex anatomy of deep brain nuclei, which could help enhance the precision of DBS procedures and may improve patient outcomes. This advanced understanding of spatial anatomical relationships may be beneficial for the continued development and success of DBS therapy.
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The endoscopic combined transseptal-transnasal technique for pituitary adenoma excision is notable for enhanced postoperative functional outcomes. Our study compared the incidence of anterior nasal septal perforation and the resulting sinonasal complications between this method and the bilateral transnasal approach. ⋯ For the surgical treatment of pituitary adenomas, the transseptal-transnasal approach offers several advantages over the bilateral transnasal method, particularly in reducing postoperative complications. However, this technique requires careful attention for preventing the occurrence of anterior septal perforation.
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Trigeminal neuralgia is a debilitating disease, with severe recurrent paroxysms of shock-like facial pain. Although pharmacotherapy may suffice in the majority of cases, a proportion of patients require surgical treatment. Gamma knife radiosurgery (GKRS) represents a potential noninvasive alternative to surgery in these patients. ⋯ GKRS is effective among patients with classic/idiopathic TN, with complete pain relief in 58.6% of patients, and adequate pain relief in 18.6% of patients. The most frequent complication is facial hypesthesia, affecting 38.6% of patients. Multiple prior failed procedures for TN significantly predict failure of pain relief at latest follow-up.
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The middle meningeal artery (MMA) is a major dural vessel that plays a significant role in developing chronic subdural hematomas (cSDHs). Understanding its variable anatomy is essential for the effective management of cSDH and the prevention of complications. ⋯ The most common configuration of MMA was Adachi-type IC. The MMA most often originated from the maxillary artery. The posterior branch of the MMA was typically dominant and most frequently originated from the distal segment. There was no significant impact of Adachi type on treatment results or fluoroscopy time.