World Neurosurg
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Video-assisted thoracic surgery (VATS) is a less-invasive alternative to open thoracotomy. According to evidence-based medicine methodology, VATS is associated with better outcomes and the same complication rate as open thoracotomy. ⋯ The two presented cases show that VATS is not without severe complications, as evidence-based medicine methodology suggests. Surgical findings in our patients imply that if this type of complication happens, early surgical exploration could be the best option for the patients.
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This study sought to report on the utility and safety of the flexible-fiber CO2 laser in endoscopic endonasal transsphenoidal surgery. ⋯ We found that CO2-laser-assisted endoscopic endonasal transsphenoidal surgery for sellar tumors is a minimally invasive approach using a tool that is quick and effective at cutting and coagulation. The surgery has a low rate of complication, and no laser-related complications were encountered. The laser fiber allows the surgeon to safely cut and coagulate without the line-of-sight problems encountered with conventional CO2 lasers. Further studies are recommended to further define its role in endoscopic endonasal sellar surgery.
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Sixty-four-row multislice computed tomographic angiography (CTA) has great potential for use in vascular studies. The aim of our study was to compare 64-slice CTA with three-dimensional rotational angiography (3DRA) in the detection and characterization of intracranial aneurysms with special attention to smaller (<3-mm) aneurysms. ⋯ Sixty-four-slice CTA is a highly accurate imaging examination of the first-line imaging technique for detecting and characterizing intracranial aneurysms including <3-mm aneurysms.
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Over 75,000 patients have undergone deep brain stimulation (DBS) procedures worldwide. Magnetic resonance imaging (MRI) is an important clinical and research tool in analyzing electrode location, documenting postoperative complications, and investigating novel symptoms in DBS patients. Functional MRI may shed light on the mechanism of action of DBS. MRI safety in DBS patients is therefore an important consideration. ⋯ The importance of MRI in modern medicine places pressure on industry to develop fully MRI-compatible DBS devices. Until then, the literature suggests that, when observing certain precautions, cranial MR images can be obtained with an extremely low risk in patients with implanted DBS hardware.
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Ventral decompressive surgery of the craniocervical junction is performed to manage a variety of conditions, including basilar invagination, which can be associated with platybasia. We have noted that the anatomic changes of platybasia could affect the height of the odontoid over a line drawn along the nasal cavity floor, the palatine line (PL). This anatomic change may influence the use of nasal endoscopic surgery for patients with platybasia who also have basilar invagination. We investigated whether the height of the craniocervical junction is elevated over the PL in patients with and without platybasia. ⋯ Platybasia is associated with an increase in the odontoid and craniocervical junction over the PL. This increase in height has implications for endoscopic approach selection in patients with platybasia. Platybasia patients with basilar invagination may be better suited to a transnasal approach.