World Neurosurg
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The aim of this study was to determine whether there are differences in pituitary apoplexy and subclinical apoplexy secondary to adenoma hemorrhage in the adolescent population with regard to symptomatology, neuroimaging features, pathology, and outcomes compared with adults. ⋯ Pituitary hemorrhage resulting in apoplexy or subclinical apoplexy in adolescents may represent a distinct entity with a more indolent symptomatology and more favorable neurologic and endocrine outcome compared with adults that is worthy of further validation in a multi-institutional cohort.
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A survey-based study was designed to assess opinions related to transsphenoidal endoscopy, to evaluate the current global attitudes of neurosurgeons regarding the use of this procedure, and to solicit basic data from key institutions worldwide, with the advantage that large series of cases become available for analysis. ⋯ Transsphenoidal endoscopy for pituitary and anterior skull base tumors has become established as a routine method of dealing with a variety of lesions. The level of interest in the neurosurgical surgery community is reflected by the geometric expansion of contributions to the literature on endoscopic surgery.
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To assess the impact of a simulation-based educational curriculum of 4 modules on neurosurgical trainees at the Neurological Societies of India annual meeting, which was held in Mumbai, India, in December 2013. ⋯ Our course suggests that a simulation-based neurosurgery curriculum has the potential to enhance resident knowledge and technical proficiency.
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Anatomic variations of the anterior clinoid process (ACP) should be recognized before clinoidectomy to ensure a safe approach. This study describes the incidence of caroticoclinoid foramen (CCF), interclinoid osseous bridge, and pneumatization of the ACP during extradural anterior clinoidectomy. The problems and technical issues encountered in such cases are described. ⋯ Preoperative computed tomography is useful to detect variations in the anatomy around the ACP. When performing extradural anterior clinoidectomy in such anomalous cases, appropriate modifications are needed to ensure a safe approach.
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To assess the histologic accuracy of endoscopic biopsy samples of the pineal region. Pineal region tumors usually present with acute hydrocephalus. Histologic diagnosis is paramount, as it greatly influences treatment. Endoscopic techniques can combine histologic diagnosis with relief of the obstructive hydrocephalus in a single operation. Because pineal region tumors can be heterogeneous, initial biopsy samples may not represent the most aggressive portion of the tumor. ⋯ The endoscopic biopsy sample yields an accurate histologic diagnosis for most pineal region tumors, with a positive histologic sample in about 85% of patients. However, the results must be interpreted cautiously, as the heterogeneous nature of these tumors may lead to an approximately 21% error rate in the initial tumor diagnosis.