World Neurosurg
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The value of preoperative repetitive transcranial magnetic stimulation (rTMS) language mapping for function preservation in surgery of speech-eloquent lesions under general anesthesia remains to be determined. ⋯ Implementation of preoperative rTMS language mapping seems to provide a favorable early language outcome in patients undergoing surgical resection of language-eloquent lesions under general anesthesia.
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Lateral approaches to treat anterior cranial fossa lesions have evolved since the first frontotemporal approach described by Dandy in 1918. We describe a less invasive approach to perform extradural anterior clinoidectomy through a lateral supraorbital (LSO) approach for anterior circulation aneurysms and anterolateral skull base lesions. ⋯ The extended LSO approach opens a new route (frontopterio-orbital window) to perform extradural anterior clinoidectomy safely and increases surgical exposure, angles, and operability of a less invasive keyhole craniotomy (LSO approach) to treat anterior cranial fossa lesions.
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A considerable number of patients suffer delayed neurologic deficits, even after a successful removal of intramedullary spinal cord ependymoma. The underlying pathology remains unknown. Radiologic findings could provide an explanation for poor outcome after surgery. ⋯ Spinal cord atrophy seems to be a predicting factor in long-term outcome after surgical removal of intramedullary spinal cord ependymoma.
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Twist drill craniostomy (TDC) is a minimally invasive and cost-effective technique to treat chronic subdural hematomas (CSDHs). Predictors for treatment success such as imaging characteristics, hematoma volume, and drainage volume are not established; thus, they are purpose of this analysis. ⋯ TDC is an effective treatment option for CSDH. Sufficient treatment with single TDC was more common in smaller hematomas with an associated smaller residual hematoma. Failure of brain re-expansion after TDC may increase the treatment failure rates. In these cases, an open surgical evacuation might accelerate treatment and clinical recovery.
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The prevalence of obesity is increasing at a disparaging rate in the United States. Although previous studies have associated obesity with increased surgical complications and readmission rates, the impact of obesity on surgical outcomes after cranial surgery remains understudied. The aim of this study is to assess the effect of obesity on complication and 30-day readmission rates after cranial surgery. ⋯ Our study suggests that obesity may not have a significant impact on surgical outcomes after cranial surgery.