World Neurosurg
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Review Meta Analysis
Intraoperative fluorescence-guided resection of high-grade gliomas: a comparison of the present techniques and evolution of future strategies.
Fluorescence guidance has a demonstrated potential in maximizing the extent of high-grade glioma resection. Different fluorophores (fluorescent biomarkers), including 5-aminolevulinic acid (5-ALA) and fluorescein, have been examined with the use of several imaging techniques. Our goal was to review the state of this technology and discuss strategies for more widespread adoption. ⋯ These techniques are safe and effective for increasing gross total resection. The development of more tumor-specific fluorophores is needed to resolve problems with subjective interpretation of fluorescent signal at tumor margins. Techniques such as quantum dots and polymer or iron oxide-based nanoparticles have shown promise as potential future tools.
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Review Meta Analysis
The prevalence of the ponticulus posticus (arcuate foramen) and its importance in the Goel-Harms procedure: meta-analysis and review of the literature.
We reviewed published radiographic and cadaver series describing the incidence of the anatomical anomaly ponticulus posticus and discuss its relevance to C1 lateral mass screw (C1LMS) insertion. ⋯ The atlantal anomaly ponticulus posticus is not rare, occurring in 16.7% of patients in radiographic and cadaver studies. This anomaly may give the false impression that the posterior arch of the atlas is of adequate size to accommodate a C1LMS and may lead to inadvertent vertebral artery injury. Careful assessment via preoperative multiplanar computed tomographic imaging should be performed before consideration of C1LMS implantation.
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Recent advances in neuroimaging demonstrated many markedly improved images hitherto unavailable, specifically the areas that lie deep in the brain. The anatomic images of the deep brain structure taken in vivo using 7.0 T magnetic resonance imaging (MRI) and the molecular images using high resolution research tomography positron emission tomography, as well as the fusion images using state-of-art neuroimaging techniques can contribute to the noninvasive treatment of neurologic and psychiatric diseases. We present a pictorial review with selected brain images obtained from 7.0 T MRI, and the images of brain metabolic function accompanied with high resolution anatomic information obtained using the positron emission tomography-MRI fusion technique. In addition, we present some recent results of the cerebral microvasculature and diffusion tractography imaging for the deep brain areas acquired with 7.0 T MRI.
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The supraorbital eyebrow craniotomy is being increasingly used for the removal of frontal fossa, parasellar, as well as some middle and posterior fossa tumors. ⋯ The supraorbital eyebrow craniotomy with endoscopic assistance provides minimally invasive access to a wide range of frontal fossa, parasellar, and some middle and posterior fossa tumors.
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To present midterm to long-term results obtained in carpal tunnel release, in situ decompression, and anterior transposition of the ulnar nerve using the retractor integrated endoscope. ⋯ The retractor-endoscopic technique provides good long-term results after carpal tunnel release, in situ decompression, and anterior subcutaneous transposition of the ulnar nerve. Outcomes showed some correlation to the duration of preoperative symptoms.