World Neurosurg
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Nontraumatic spontaneous atlanto-occipital dislocation (AOD) is rare. In this report, we discuss the technical steps of condylar joint fusion and stabilization (by screws and plates) in nontraumatic AOD. To the best of our knowledge, it is the first report of such techniques. ⋯ Condylar joint stabilization and fusion may be a good or alternative option for AOD.
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Case Reports
Guidewire Breakage During Cavernous Sinus Sampling: A Rare Complication and Its Treatment.
Venous sampling methods are valuable tools for the diagnosis of pituitary adenomas. However, these interventions also have complications, which may complicate the treatment process. ⋯ Current surgical experience on endoscopic skull base surgery allows management of diagnostic complications related to the cavernous sinus, such as safe access to materials which were inadvertently left during CSS, without the necessity for further interventions.
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This study aimed to characterize pyramidal tract shift in different regions of the brain during glioma resection and its association with head position and tumor location. ⋯ Direction of pyramidal tract shift in 3 dimensions is unpredictable; hence shift radius is a more clinical useful concept. Shift radius was largest above the ventricles and was strongly influenced by head position, with a trend for temporal lobe tumors to exhibit larger shifts.
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The aim of this international survey was to investigate the current management of patients undergoing surgery for chronic subdural hematoma (cSDH) treated with low-dose acetylsalicylic acid (ASA). ⋯ Most neurosurgeons discontinue ASA treatment for at least 7 days in the perioperative period of surgical evacuation of cSDH, even though recent studies show that early ASA resumption might be safe. Thrombosis prophylaxis is administered by only 60%, even though patients with cSDH are at high risk of developing thromboembolic complications. Better evidence and guidelines are warranted because the incidence of patients with cSDH under the treatment of ASA is increasing.
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Gamma Knife radiosurgery (GKS) for the treatment of vestibular schwannoma (VS) introduces risks to the facial nerve and auditory perception and may involve post-treatment complications such as pseudoprogression, hydrocephalus, and other cranial neuropathies. This study of patients with VS who underwent GKS investigated radiosurgical results, focusing on post-treatment complications and identifying the factors that predict such complications. ⋯ Further prospective studies should be designed to provide further insight into the exact relationship between the predictive factors we investigated and post-treatment complications.