World Neurosurg
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Case Reports
Endoscopic middle cranial fossa reconstruction via a subtemporal keyhole: A technical note.
Skull base reconstruction is an essential technique for repairing cerebrospinal fluid (CSF) leakage. A reliable method for middle cranial fossa (MCF) reconstruction with minimal invasiveness has not been reported. An initial case of endoscopic MCF reconstruction with a subtemporal keyhole is described. ⋯ This purely endoscopic technique using a vascularized DTF flap provided reliable MCF reconstruction through a subtemporal keyhole. This technique is also expected to be applicable for MCF reconstruction after subtemporal keyhole surgery for skull base tumors.
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Craniopharyngiomas have traditionally been treated via open transcranial approaches. More recently, endoscopic transsphenoidal approaches have been increasingly used; however, few case series exist in the pediatric population. ⋯ Endoscopic transsphenoidal resection for craniopharyngiomas can achieve high rates of total resection with low rates of disease recurrence in larger tumors than previously described. However, hypothalamic-pituitary dysfunction and cerebrospinal fluid leak remain significant postoperative morbidities.
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Selection of the access myelotomy is a key issue in surgery for spinal intramedullary tumors. This study focused on surgical outcomes with the posterolateral sulcus (PLS) approach, equivalent to dorsal root entry zone myelotomy. ⋯ These findings suggest that the PLS approach can provide direct access to tumors with minimal tissue damage, when applied appropriately after careful case selection.
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Isolated chronic middle cerebral artery occlusion (ChMCAO) is not a rare condition and is known to cause hemodynamic stroke. The purpose of this study was to evaluate differences in clinical manifestations and prognosis of isolated ChMCAO in relation to angiographic features. ⋯ AF through the basal collateral network may be related to clinical manifestations of ChMCAO. Good AF in isolated ChMCAO may play an important role in preventing recurrence of an ischemic event.
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Approximately 30% of patients treated with foramen magnum decompression (FMD) for Chiari I-associated syringomyelia will show persistence, recurrence, or progression of the syrinx. ⋯ SSS for persistent, recurrent, or increasing syrinx following FMD for Chiari I malformation is a safe and effective surgical treatment when performed selectively by an experienced neurosurgeon.