World Neurosurg
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Comparative Study
The Role of Endoscopic Assistance in Ambient Cistern Surgery: Analysis of Four Surgical Approaches.
We used microscopy with endoscopic assistance to conduct an objective analysis of 4 surgical approaches commonly used in the surgery of the ambient cistern: infratentorial supracerebellar (SC), occipital interhemispheric (OI), subtemporal (ST), and transchoroideal (TC). In addition, we performed a parahippocampalis gyrus resection in the ST context. ⋯ This study demonstrates that endoscope assistance improved exposure of the ambient cistern region when using the ST approach. Endoscopic assistance provided similar surgical exposure compared with ST associated with parahippocampalis resection.
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Recommended treatments for spontaneous intracranial hypotension (SIH) range from bed rest only to neurosurgery. However, the serious form of SIH is poorly defined. A better description of patient characteristics and their outcome may help define therapeutic options. ⋯ The presence of SDHs, disturbance of consciousness, and a trend toward a longer time to diagnosis and recovery seem to define the serious form of SIH. These patients may require exploration and surgical repair of cerebrospinal fluid leak, only after failure of conservative measures--bed rest and time--and EBP, with good outcome.
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To evaluate a cranial base repair method using the dural suturing technique in combination with a mucosal flap in the endoscopic endonasal approach. ⋯ Our graded cranial base repair method using the dural suturing technique is simple and reliable.
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In the pediatric population, awake craniotomy began to be used for the resection of brain tumor located close to eloquent areas. Some specificities must be taken into account to adapt this method to children. ⋯ Preoperative preparation and hypnosis in children seemed important for performing awake craniotomy and contributing language brain mapping with the best possible psychological experience. The pediatrics specificities are discussed.
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We aimed to determine the diagnostic yield and safety of posterior fossa parenchymal biopsy. ⋯ The diagnostic yield of posterior fossa parenchymal biopsy in Mayo Clinic patients with diverse pathologies was 80%. The complication rate was 11% with the majority being transient, but 2 deaths were attributed to biopsy. Evaluation of the diagnostic yield and complication rate at individual neurosurgical centers is needed to determine generalizability of these results.