World Neurosurg
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Piezosurgery uses microvibrations to selectively cut bone, preserving the adjacent soft tissue. The present study evaluated the use of piezosurgery for bone removal in orbital decompression surgery in Graves disease via a modified pterional approach. ⋯ Piezosurgery proved to be a useful tool in bone removal for orbital decompression in Graves disease. It is safe and easy to perform, without any danger of damage to adjacent tissue because of its selective bone-cutting properties. Nonetheless, further development of the device is necessary to overcome the disadvantages in intraoperative handling and the reduced bone removal rate.
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Case Reports
Endoscopic endonasal resection of a mixedlesion of gangliocytoma and non-functioning pituitary adenoma.
The coexistence of a gangliocytoma and a pituitary adenoma is a rare event that has been reported in only case reports. The knowledge of its diagnosis and treatment is extremely limited. ⋯ Our finding of the heterogeneous texture in the lesion of gangliocytoma associated with pituitary adenoma may help to uncover the pathogenesis of this rare disorder. This finding also supports the examination of intraoperative frozen sections to aid in diagnosis. We recommend maximized safe resection as a surgical strategy for the coexistent lesion of gangliocytoma and pituitary adenoma.
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The patient is a 79-year-old male, suffering from advanced metastatic prostate cancer, who developed a progressively worsening ideomotor slowing and was therefore referred to the emergency department of our institution. A plain axial computed tomography (CT) scan revealed a vast hemispheric subdural fluid collection, apparently a subdural hematoma. ⋯ The total body CT scan for the routine oncologic follow-up of the prostate cancer scan fell at 20 days from the first CT of the emergency department. A second contrast-enhanced axial CT scan demonstrated the presence of 2 subdural metastases, presumably the initial pathogenesis of the subdural fluid collection.
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Postoperative neurologic outcomes after primary somatosensory cortex (S1) resection have not been well documented. This study was designed to evaluate the neurologic deterioration that follows resection of the S1 areas and to assess the risk factors associated with these morbidities. ⋯ The neurologic risk of the resection of S1 and/or its adjacent cortical areas was 40%. The additional resection of the PPC was significantly associated with the development of postoperative neurologic impairments.