World Neurosurg
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We report a challenging case of a high cervical schwannoma with involvement of the right vertebral artery that could not be sacrificed. We discuss the clinical presentation, surgical approach/techniques, and brief literature review of cervical schwannomas. Our case includes a 58-year-old male referred to neurosurgery due to worsening pain and ataxia, who was found to have a large right sided cervical mass. ⋯ A series evaluating similar tumors determined that the extent of involvement of the vertebral artery predicts the extent of resection[5]. Our case demonstrates the key steps required for dissecting the vertebral artery in order to safely achieve gross total resection. The patient provided consent for treatment and to allow his interesting case to be utilized for scientific review and publication.
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Stroke is a leading cause of death in the United States, with significant economic and human costs. Early diagnosis and rapid treatment are critical for preventing stroke-related morbidity and mortality. However, accessibility to neurointerventional medical centers remains a challenge for many Americans, highlighting the need for innovative solutions to improve stroke management. ⋯ Robotically assisted cerebral angiography shows potential as a valuable tool in neuroendovascular interventions. Addressing technical challenges and conducting further research will be crucial to fully realize the clinical benefits of this innovative technology and improve patient outcomes in stroke management.
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Cerebral hyperperfusion syndrome (CHS) is a critical complicationin patients underwent carotid artery stenting (CAS). We sought to explore neurosonological parameters and additional risk factors associated with CHS in patients following CAS and further to develop a prediction model for CHS after CAS. ⋯ In this study, CHS following CAS was associated with ECC, ARP, contralateral ICA severe stenosis or occlusion, as well as LDL-C. Subsequently, the CHS prediction model for CAS was built, which has the potential to facilitate tailored and precise management as well as treatment strategies for patients at high risk of CHS.
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Neurosurgery relies heavily on advanced manual skills, necessitating effective training models for skill development. While various models have been utilized, the human placenta has emerged as a promising candidate for microneurosurgical training due to its anatomical similarities with cerebral vasculature. However, existing placenta models have primarily focused on simulating superficial procedures, often neglecting the complexities encountered in deep operative fields during cranial surgeries. ⋯ The presented modified placenta model serves as an effective tool for simulating the conditions encountered in deep cranial surgeries. By accurately replicating the challenges of deep operative fields, the model significantly enhances the training of neurosurgical residents. It successfully prepares trainees to navigate the intricacies and difficulties inherent in real cranial surgeries, thus contributing to improved surgical skills and readiness for neurosurgical practice.
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The purpose of this study was to describe the impact of enteral glyburide on cerebral edema formation and hypoglycemia when used in patients diagnosed with acute ischemic stroke (AIS). ⋯ Despite relatively low rates of intervention for cerebral edema, hypoglycemia was common, particularly in patients receiving 5-7 doses of enteral glyburide for the prevention of cerebral edema in patients with moderate-to-severe AIS.