World Neurosurg
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Case Reports
Indocyanine green (ICG) temporary clipping test to assess collateral circulation before venous sacrifice.
As a general principle, sacrifice of cerebral veins at surgery is avoided. However, at times sacrifice of a vein may be desirable to increase surgical exposure. At present, no method exists to predict whether such sacrifice will be accommodated by the presence of collateral venous drainage. We show a simple technique to examine cerebral venous blood flow using indocyanine green videoangiography. ⋯ Although our limited study cannot prove that venous congestion or infarction can be avoided with this technique, it does provide direct evidence of the presence or absence of collaterals that can help guide intraoperative surgical decision-making.
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The coexistence of a primary brain tumor such as high-grade glioma and superimposed abscess is a rare entity and can present a diagnostic and therapeutic challenge. The concomitant abscess may not be recognized until surgery, and the overall course of treatment may require adjustment in the presence of a coinciding infection. In the present report we evaluate the diagnosis and treatment of a glioblastoma multiforme with an intratumoral abscess. ⋯ There are insufficient guidelines on the treatment of a primary brain tumor with intratumoral abscess. In this report we present our therapeutic decisions in this rare case.
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Anterior cervical discectomy and fusion (ACDF) procedures are increasingly being managed on an outpatient basis. Currently there are no definitive guidelines within the literature that delineate which patient population can safely be managed as such. The purpose of this study is to demonstrate that ACDF procedures, within a selective patient population at our institution, can be safely performed on an outpatient basis. ⋯ ACDF procedures involving single and two-level fusions can safely be performed on an outpatient basis. Complication rates associated with this procedure are low, with critical postoperative complications involving respiratory compromise occurring very infrequently and in the immediate postoperative period.