Neurosurgery
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The Pipeline Embolization Device (PED) is a treatment modality for wide-neck complex intracranial aneurysms. There have been recent reports for the use of PEDs in dissecting pseudoaneurysms of the cervical carotid arteries. The use of this flow diversion technology has emerged as a promising alternative; however, there are various risks and complications that one should be aware of. ⋯ ICA, internal carotid arteryPED, Pipeline Embolization Device.
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External ventricular drains (EVDs) are routinely placed as part of the management of intracranial hypertension. Pseudoaneurysm formation after EVD placement is a rare complication that can occur as a result of direct trauma to the cerebral vasculature. Prompt recognition and treatment may prevent future rupture. ⋯ ACA, anterior cerebral arteryEVD, external ventricular drain.
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Surgery is indicated for cerebral cavernous malformations (CCMs) that cause medically refractory epilepsy. Real-time magnetic resonance thermography (MRT)-guided stereotactic laser ablation (SLA) is a minimally invasive approach to treating focal brain lesions. SLA of CCM has not previously been described. ⋯ CCM, cerebral cavernous malformationsGRE, gradient recalled echoMRT, magnetic resonance thermographySLA, stereotactic laser ablation.
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The cervical carotid system has been used as a source of donor vessels for radial artery or saphenous vein grafts in cerebral bypass. Recently, internal maxillary artery to middle cerebral artery bypass has been described as an alternative, with reduction of graft length potentially correlating with improved patency. ⋯ EI-IC, external carotid-internal carotidICA, internal carotid arteryIMax-MCA, internal maxillary artery to middle cerebral arteryMCA, middle cerebral arteryRAG, radial artery graft.
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Brain tumors are complex 3-dimensional lesions. Their resection involves training and the use of the multiple microsurgical techniques available for removal. Simulation models, with haptic and visual realism, may be useful for improving the bimanual technical skills of neurosurgical residents and neurosurgeons, potentially decreasing surgical errors and thus improving patient outcomes. ⋯ VR, virtual reality.