World Neurosurg
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Review Case Reports
Triple-stent therapy for the treatment of vertebral dissecting aneurysms: Efficacy and safety.
There are several treatment modalities for vertebral dissecting aneurysms. The purpose of this study was to evaluate the efficacy and safety of triple stent therapy for intracranial vertebral dissecting aneurysm (VDA). ⋯ Triple stent therapy for VDAs was safe and effective. This technique showed favorable results in clinical and imaging follow-up for unruptured VDAs, although caution is advised for ruptured VDAs.
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In Japan, neurosurgeons have traditionally mainly treated brain diseases, with most cases involving the spine and spinal diseases historically being treated by orthopedists. Nowadays, spinal surgery is 1 of the many subspecialties in the neurosurgical field in Japan. ⋯ Neurosurgeons in Japan must rethink the educational program to include advanced trauma life support and spinal surgery.
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Despite selection process before awake-craniotomy, some patients experience an unexpected decline in language functions in the operating room (OR), compared with their baseline evaluation, which may impair their functional monitoring. To investigate this phenomenon we prospectively compared language function the day before surgery and on entrance to the OR. ⋯ Patients undergoing awake-craniotomy may experience a substantial decline in language functioning after entering the OR. Tumor grade and the presence of preoperative language deficits were significant risk factors for this phenomenon, suggesting a possible relation between cognitive reserve, psychobehavioral coping abilities and histologic features of a tumor involving language areas. Capturing and identifying this unique population of patients who are prone to experience such language decline may improve our ability in the future to select patients eligible for awake-craniotomy.
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To investigate the common complications from the microsurgical treatment of large intracranial vestibular schwannoma (VS) via suboccipital retrosigmoid approach and to propose strategies for minimizing such complications. ⋯ The key factors for reducing surgical complications include careful assessment of the functions of acoustic and facial nerves as well as a thorough understanding of anatomy via the retrosigmoid approach before operation, skillful microsurgical technique, and monitoring of multiple cranial nerves during resection.
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Racial disparities have been shown to affect surgical outcomes. However, the effect of race on complex spinal fusion outcomes remains understudied. The aim of this study is to determine if patient race affects 30-day complication rates after elective complex spinal fusion (≥5 levels). ⋯ Our study suggests that there is no difference between races in 30-day complication and readmission rates after complex spinal surgery requiring ≥5 levels of fusion.