World Neurosurg
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To investigate gamma knife radiosurgery (GKS) for benign tumor-associated secondary trigeminal neuralgia (TN). ⋯ Here we show the reproducible feasibility of a 2-session GKS procedure using higher radiation doses, the first dose to treat the tumor and the second to treat the trigeminal nerves using retrogasserian targeting.
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The purpose of this report is to describe the surgical methodology and effectiveness of minimally invasive oblique lumbar interbody fusion (OLIF) assisted by spinal endoscopy, which can treat disk herniation from the central to contralateral foramen. OLIF showed indirect decompression effects on reduction of spondylolisthesis and a foraminal widening effect on disk height restoration. ⋯ OLIF with spinal endoscopic discectomy can achieve neural decompression without additional posterior decompression and can be used as an alternative treatment in selected cases.
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Neurosurgery simulation has gained attention recently due to changes in the medical system. First-year neurosurgical residents in low-income countries usually perform their first craniotomy on a real subject. Development of high-fidelity, cheap, and largely available simulators is a challenge in residency training. An original model for the first steps of craniotomy with cerebrospinal fluid leak avoidance practice using a coconut is described. ⋯ The model has a potential pedagogic neurosurgical application for freshman residents before they perform a real craniotomy for the first time. Further validity is necessary to confirm this hypothesis.
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Pituitary tumor apoplexy can result from either hemorrhagic or infarctive expansion of pituitary adenomas, and the related mass effect can result in compression of critical neurovascular structures. The time course of recovery of visual field deficits, headaches, ophthalmoparesis, and pituitary dysfunction after endoscopic transsphenoidal surgery has not been well established. ⋯ Endoscopic transsphenoidal surgery can provide durable resolution of symptoms for patients presenting with pituitary tumor apoplexy. Recovery from headaches, visual, and pituitary dysfunction may be more rapid compared with ophthalmoparesis.
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The application of bypass procedures to the posterior cerebral artery (PCA) in combination with proximal clipping or trapping is a useful option for the treatment of complex posterior circulation aneurysms, especially those of the PCA. Because of its course around the midbrain through various cisterns, different approaches are required to access the PCA. ⋯ Bypass revascularization of the PCA territory is effective for the treatment of complex vascular lesions affecting the posterior circulation. To address the various surgical segments of the PCA, different approaches are required. Combined approaches allow access to the PCA proximal and distal from the lesion.