Neurosurgery
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Case Reports
Functional monitoring for visual pathway using real-time visual evoked potentials and optic-radiation tractography.
It has been difficult to obtain anatomic and functional information about the visual pathway during neurosurgical operations. The aim of this study was to combine the information of the visual evoked potentials (VEPs) and the anatomic navigation of the optic radiation by diffusion tensor imaging-based tractography for functional monitoring of the visual pathway. ⋯ We confirmed functional correlations of the results of diffusion tensor imaging-based tractography by monitoring intraoperative VEPs. The combination of continuous VEP and optic-radiation tractography is reliable to monitor the visual function and is helpful in performing neurosurgical planning near the visual pathway.
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Although rare in developed countries, hydatid disease is a serious parasitic infection in endemic areas. Spinal disease most commonly involves the thoracic region, and involvement of the upper cervical spine is extremely rare. In this report, a case of hydatid disease involving the craniocervical junction is presented, along with a review of the literature. ⋯ Hydatid disease should be considered in the differential diagnosis of spinal cord compression, especially in endemic areas. Although the chance of obtaining a cure is unlikely, radical surgery coupled with antihelminthic therapy seems to provide long-lasting relief.
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The objective of this study was to evaluate the clinical significance of the transforaminal ligaments (TFLs) in relation to the area of the lumbar intervertebral foramen (IVF) by analyzing cadaveric spines. ⋯ TFLs are common structures in the IVF and may reduce the space available for the spinal nerve root within the IVF. In this circumstance, any compromise of the IVF may impinge on the nerve root.
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To evaluate the interest of integrating positron emission tomography (PET) images with the radiolabeled tracer [(11)C]methionine (Met) into the image-guided navigation planning of infiltrative low-grade brain tumors (LGBTs) in children. ⋯ These data suggested that Met-PET guidance could help to improve the number of total resections and the amount of tumor removed in infiltrative LGBTs in children.
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Effect of the neurosurgeon's surgical experience on outcomes from intraoperative aneurysmal rupture.
The neurosurgeon's surgical experience is one of the most important and least studied factors affecting a patient's outcome after an intraoperative rupture of an aneurysm. Therefore, this analysis was undertaken to evaluate the effect of the neurosurgeon's experience on the management of this catastrophe in a consecutive series of patients treated microsurgically. ⋯ Intraoperative rupture is an unavoidable danger in aneurysm surgery that does not diminish with increasing surgical experience of the neurosurgeon performing the operation. However, experience did improve the neurosurgeon's response to aneurysm rupture and the patients' outcomes. Mental anticipation and technical repetition over time transform into efficiency, confidence, and insight in the management of this distressing intraoperative event.