World Neurosurg
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Spinal artery aneurysms are rare lesions that can occur in isolation or may be attributed to a variety of secondary causes. Chronic bilateral vertebral artery occlusion is an exceedingly rare cause of anterior spinal artery aneurysm, with only one previous case reported in the literature. Surgical treatment of ventrally located anterior spinal artery aneurysms situated at the craniocervical junction presents particular challenges related to the operative approach, which may entail high cervical anterior exposure, posterolateral complete facetectomy/pediculectomy, or far lateral skull base approaches, among others. ⋯ This report highlights an exceedingly rare cause of anterior spinal artery aneurysm and emphasizes the utility and technical aspects of the posterior approach with spinal cord rotation.
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Data from single-institution studies suggest that perioperative complication rates after stereotactic needle brain biopsies range from 6% to 12%, with permanent morbidity and mortality ranging from 3.1% to 6.4% and 0% to 1.7%, respectively. However, no population-level data are available. We conducted a population-based analysis to study complications after needle brain biopsy. ⋯ Intracranial hemorrhage is the most frequent complication associated with needle brain biopsy and is associated with inpatient mortality and hospital disposition. Other complications are rare.
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The transsphenoidal approach was initially developed in neurosurgical practice as an operative approach to the pituitary gland. The introduction of the operating endoscope has improved the versatility of the transsphenoidal approach, broadening the spectrum of lesions that can be treated effectively with this operative strategy. ⋯ Although initially devised in neurosurgical practice for tumors of the pituitary gland, developments in technology now make the transsphenoidal approach an effective operative strategy for a wide range of anterior skull base lesions.
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Review Meta Analysis
Intracerebral Hemorrhage: A Common and Devastating Disease in Need of Better Treatment.
To review the poor natural history of intracerebral hemorrhage (ICH), current treatment options for ICH, discuss ongoing trials evaluating minimally invasive techniques for clot evacuation, and offer future directions of investigation for the management of this devastating disease. ⋯ Treatment of ICH is an important area of research and should continue to be aggressively pursued because of the significant societal burden and poor outcomes associated with ICH.
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Review Biography Historical Article
The Legacy of Henry Molaison (1926-2008) and the Impact of His Bilateral Mesial Temporal Lobe Surgery on the Study of Human Memory.
In 1953, neurosurgeon William Beecher Scoville performed a bilateral mesial temporal lobe resection on patient Henry Molaison, who suffered from epilepsy. The operation was novel as a treatment for epilepsy and had an unexpected consequence: a severe compromise of Molaison's anterograde memory. In a landmark 1957 publication, Scoville and Milner concluded that mesial temporal lobe structures, particularly the hippocampi, were integral to the formation of new, recent memories. ⋯ Histological evaluation of Molaison's brain further elucidated which mesial temporal lobe structures were preserved or resected in his operation, shedding new light on the neuroanatomic underpinnings of short-term memory. Scoville regretted Molaison's surgical outcome and spoke vigorously about the dangers of bilateral mesial temporal lobe surgery. This report is the first historical account of Molaison's case in the neurosurgical literature, serving as a reminder of Molaison's contributions and of the perils of bilateral mesial temporal lobe surgery.