World Neurosurg
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Intraoperative direct stimulation during surgery while awake is considered to be the gold standard for identifying eloquent cortical sites. Only a few studies have referenced the psychologic impact of this event in the pediatric population. ⋯ The results are encouraging, allowing us to contemplate using brain surgery while awake for children without particular worries about the psychologic aspect.
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Case Reports
Frameless and Maskless Stereotactic Navigation with a Skull-Mounted Tracker:A Technical Report.
In this series, we present 3 cases that show the use of a skull-mounted tracker for image-guided navigation for anterior skull base surgery and ventricular catheter placement procedures. This system obviates fiducials or face masks during the surgical procedure itself and allows for the performance of facial incisions using the Weber-Ferguson approach. ⋯ Intraoperative image-guided navigation has revolutionized neurosurgery. It undoubtedly increases the surgeon's confidence and the perception of safety. Although fiducials and facial masks are the most widely used tools for intraoperative navigation, their use is associated with certain complications. This technique permits free movement of the head during surgery, which in turn facilitates the exposure of head and neck lesions and expedites the approach to ventricular catheter placement. Our case series shows the precision and ease of our technique, which is less time consuming and less cumbersome than the traditional frame-based stereotaxy. In addition, the skull-mounted tracker system allows improved anatomic localization and shorter operating time and avoids the complications associated with the use of rigid fixating head frames.
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Complications after surgery for mesial temporal lobe epilepsy associated with hippocampal sclerosis.
Hippocampal sclerosis is the most common cause of drug-resistant epilepsy amenable for surgical treatment and seizure control. This study aimed to analyze morbidities related to surgery of mesial temporal lobe epilepsy associated with hippocampal sclerosis and to identify possible risk factors for complications. ⋯ Major complications occur rarely after mesial temporal surgery on epileptic patients. They occur more often following the ATL rather than transcortical SAH approach. Complications tend to be temporary with symptoms of limited duration for surgery performed by experienced teams on carefully selected and evaluated patients.
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To examine operative findings and outcome of microvascular decompression (MVD) for glossopharyngeal neuralgia (GPN). This research displayed the long-term outcomes of a large series of 35 cases with GPN treated with MVD. ⋯ Classic GPN is usually caused by pulsatile neurovascular compression of the glossopharyngeal and vagus rootlets. MVD is a safe, effective, and durable operation for GPN.