World Neurosurg
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Hemifacial spasm occurs when a blood vessel compresses against an area near the root exit zone of the facial nerve. Developments in diagnostic neuroimaging have allowed three-dimensional (3D) observation of artery and nerve locations, an effective aid for treatment selection. However, an accurate interpretation of the 3D data remains challenging because imaging representations of complex small vessels are drowned out by noise. We used a noise elimination method to analyze artery and nerve locations and to determine their 3D relationship. ⋯ An accurate identification of the offending arteries and compression sites was possible, and this method is anticipated to offer effective means of preoperative simulation.
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The medical infrastructure of Iraqi Kurdistan, a semiautonomous region in the northern part of Iraq, lags disproportionately behind relative to the otherwise booming industrial advances of the region. Although neurosurgical training is available, the local population lacks trust in its own neurosurgeons. ⋯ Over the last 4 years, the visiting neurosurgical team has seen hundreds of patients in consultation and performed more than 50 complex cranial and spinal operations jointly with local neurosurgeons. This article discusses our experience as volunteer neurosurgeons in building neurosurgical capacity in Iraqi Kurdistan.
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Review Case Reports
Intraparenchymal meningioma: clinical, radiological, and histological review.
Although meningiomas are usually attached to the dura matter, intraparenchymal and subcortical meningiomas do not show dural attachment. ⋯ Because of the unique features described earlier, which contrast with those of ordinary meningiomas, there is a possibility that intraparenchymal meningiomas are not precisely diagnosed. Collectively, the information collected from the study cases may facilitate the appropriate management of these rare tumors.
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Randomized Controlled Trial
Opening the Internal Hematoma Membrane does not Alter the Recurrence Rate of Chronic Subdural Hematomas - A Prospective Randomized Trial.
Factors determining the recurrence of chronic subdural hematomas (CSDHs) are not clear. Whether opening the so-called internal hematoma membrane is useful has not been investigated. ⋯ Opening the internal hematoma membrane does not alter the rate of patients requiring revision surgery and the number of patients showing a marked residual hematoma 6 weeks after evacuation of a CSDH.
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Review Case Reports
De novo aneurysm associated with superficial temporal artery to middle cerebral artery bypass: report of two cases and review of literature.
De novo aneurysm formation has been reported as a rare complication of superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery. ⋯ Persistent hemodynamic stress with hypertension in an artificial T-shaped vasculature and traumatic injury during surgical manipulation are the most important causes for de novo aneurysms after STA-MCA bypass. Follow-up magnetic resonance and computed tomography angiography examinations, along with appropriate blood pressure control, are recommended for patients who have undergone STA-MCA bypass surgery.