World Neurosurg
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Case Reports
Endoscopic endonasal clipping of intracranial aneurysms: Surgical Technique and Results.
Microsurgical clipping of intracranial aneurysms requires meticulous technique and is usually performed through open approaches. Endoscopic endonasal clipping of intracranial aneurysms may use the same techniques through an alternative corridor. The aim of this article is to report a series of patients who underwent an endoscopic endonasal approach (EEA) for microsurgical clipping of intracranial aneurysms. ⋯ EEAs can provide direct access for microsurgical clipping of rare and carefully selected intracranial aneurysms. The basic principles of cerebrovascular surgery have to be followed throughout the procedure. These surgeries require a skull base team with a neurosurgeon well versed in both endoscopic endonasal and cerebrovascular surgery, working in concert with an otolaryngologist experienced in skull base endoscopy and reconstruction.
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Randomized Controlled Trial
Visual field preservation in surgery of occipital arteriovenous malformations: A prospective study.
We reviewed our prospective study of patients with occipital arteriovenous malformations (AVMs) to assess whether the display of optic radiation diffusion tensor imaging (DTI) during neuronavigation-guided surgery can reduce the severity of postoperative visual field deficits (VFDs) and to evaluate the factors associated with visual field preservation. ⋯ A history of hemorrhage is an independent risk factor for VFDs associated with occipital AVMs. Although not showing superiority in postoperative mRS, functional MRI navigation-guided surgery may help to radically resect occipital AVMs and preserve patient visual fields. A 5-mm distance from the optic radiation may be a suitable safety margin for visual field preservation.
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Comparative Study
The Utility of Dual-Energy Computed Tomographic Angiography for the Evaluation of Brain Aneurysms after Surgical Clipping: A Prospective Study.
The purpose of this prospective study was to compare a novel dual-energy computed tomographic angiography (DECTA) method for postoperative assessment of clipped brain aneurysms to detect aneurysm remnants and parent artery patency, with catheter-based digital subtraction angiography (DSA). ⋯ DECTA is a promising noninvasive alternative to conventional catheter-based angiography for identification of aneurysm remnants and assessment of adjacent arteries after surgical clipping of brain aneurysms treated by 2 or fewer clips. It allows for a more rapid image acquisition than DSA, is more cost effective, and is widely available at clinical centers.
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Case Reports
Aqueductal Stenosis Has a New Dimension-Aspergillosis: A Rare Case Report and Review of the Literature.
Cerebral aspergillosis, often encountered in immunocompromised patients, is almost always fatal despite radical surgical and medical management and frequently is a finding at autopsy. Attempts at fungal isolation often are unsuccessful, and a high index of radiologic suspicion is necessary. ⋯ At discharge on the 7th postoperative day, 4 weeks and 12 weeks later (ie, first and second follow-up) the child was active, playful, and feeding normally. The first reported case of an aqueductal stenosis due to aspergillosis was in 2000 by van Landeghem FK et al. (Clin Neuropathol 19:26-29, 2000). To the best of our knowledge, this may only be the second reported case of hydrocephalus attributable to aqueductal stenosis caused by Aspergillosis. In conclusion, aspergillosis should not be ruled out as a differential diagnosis in aqueductal stenosis, even when the patient seems to be immunocompetent.