Surg Neurol
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Endovascular coil treatment is being used increasingly as an alternative to clipping for some ruptured intracranial aneurysms. The relative benefits of these 2 approaches have yet to be fully established. The aim of this study was to compare the clinical outcome, resource consumption, and cost-effectiveness of endovascular treatment vs surgical clipping in a developing country. ⋯ Patients with aneurysmal SAH whom we judged to require coiling had higher charges than patients who could be treated by clipping. The benefits of apparent decrease in length of stay in the endovascular group were offset by higher procedure price and cost of consumables. There was no significant difference in clinical outcome at 6 months. We have proposed a risk scoring system to give guidelines regarding the choice of treatment considering size of aneurysm and resource allocation.
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Superficial vascular anatomy of the medial prefrontal cortex, which is exposed after craniotomy for the anterior interhemispheric approach, has received little attention in the anatomy literature. This study focuses on the precise vascular anatomy of the medial part of the prefrontal cortex and provides more detailed information for surgery. ⋯ The surface of the medial prefrontal cortex has a rich and complex vascular network and represents the first obstacle for surgery. The upper part of the medial prefrontal cortex seems safer than the lower part; the CS is a reliable and crucial landmark in planning and performing surgery in this region.
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The efficacy and the minimally invasive nature of the fully transnasal endoscopic procedure in the treatment of pituitary adenomas and other lesions of the sellar area have been widely reported in the literature. Many authors observed similar results in terms of the correction of hormonal hypersecretion in functioning pituitary adenomas using endoscopic endonasal surgery or the traditional microscopic technique. We report the endocrinologic outcome in 2 series of patients operated on at the same institution for functioning pituitary adenomas using these 2 different techniques. ⋯ In our experience, fully endoscopic transsphenoidal surgery for functioning pituitary adenomas leads to a better endocrinologic outcome for noninvasive macroadenomas compared to the traditional microsurgical technique. However, morbidity with the endoscopic technique was higher in terms of the rate of postoperative CSF leaks.