World Neurosurg
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Review Meta Analysis
Current treatment options for cerebral arteriovenous malformations in pregnancy: a review of the literature.
Cerebral arteriovenous malformations (AVMs), though relatively rare, have the propensity to cause potentially fatal conditions, such as intracranial hemorrhage. ⋯ An individualized, multimodal therapeutic strategy should be employed for endovascular treatment, such as presurgical embolization.
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Review Case Reports Meta Analysis Comparative Study
Effectiveness of burr holes for indirect revascularization in patients with moyamoya disease-a review of the literature.
Moyamoya disease (MMD) has inspired the development and refinement of numerous surgical techniques to induce revascularization in hypoperfused territories. Over the last 3 decades, the use of burr hole surgery has progressively gained popularity. Used either in combination with another direct or indirect procedure or as the sole method for revascularization, burr hole surgery can be tailored to each patient's specific needs. We reviewed the conceptual progress, the technical evolution, and the clinical and radiological data following burr hole surgery. ⋯ Burr hole surgery is an important and versatile tool in the armamentarium of surgeons treating children and adults with MMD, allowing tailoring of the revascularization. Further studies should help to determine factors that may help predict optimal revascularization from this surgical technique.
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Intracranially invasive sino-orbital aspergillosis is a rare entity seen predominantly in immunocompromised individuals. We report a unique case of an acute chiasmal abscess resulting from perineural extension of an indolent invasive sino-orbital aspergillosis in an immunocompetent patient. ⋯ The case demonstrates that it is possible to successfully control advanced intracranial aspergillosis with tissue-sparing surgery and adjuvant antifungal chemotherapy in immunocompetent individuals.
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To review the experience at a single institution with motor evoked potential (MEP) monitoring during intracranial aneurysm surgery to determine the incidence of unacceptable movement. ⋯ With the anesthetic and monitoring regimen, the authors were able to record MEPs of the upper and lower extremities in all patients and found only 3.2% demonstrated unacceptable movement. With a suitable anesthetic technique, MEP monitoring in the upper and lower extremities appears to be feasible in most patients and should not be withheld because of concern for movement during neurovascular surgery.
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To analyze the actual risk for patients with a patent foramen ovale (PFO) to experience a clinically relevant venous air embolism (VAE) during surgery performed in the semisitting position. ⋯ Under standardized anesthesia and neurosurgical protocols, patients with a PFO can be operated on safely in the semisitting position.