Neurosurgery
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Although endovascular technique and related devices continue to improve, recanalization of embolized aneurysm remains a pitfall of this approach. The problem of how to treat the recanalized aneurysm needs to be addressed. ⋯ Stent implantation, as well as compact coil packing, at the time of repeat embolization seems beneficial in reducing rates of further recanalization.
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Microsurgical vascular anastomosis techniques are technically challenging and used in only a narrow spectrum of neurosurgical procedures. Opportunities for instruction and application have become increasingly rare during standard neurosurgery residencies. ⋯ Despite the decrease in frequency, indications for bypass procedures still exist in neurosurgery. The fresh tissue pressurization model offers significant benefits when training neurosurgeons to perform these technically demanding procedures.
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In brachial plexus injuries, when there are no available roots to use as a source for graft reconstruction, nerve transfers emerge as an elective technique. For this purpose, transfer of an ulnar nerve fascicle to the biceps motor branch (Oberlin's procedure) is often used. Despite the high rate of good to excellent results in adults, this technique is seldom used in children. ⋯ Oberlin's procedure is an effective and safe option for the surgical treatment of upper brachial plexus birth palsy.