World Neurosurg
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Hydrocephalus develops in up to 90% of patients born with myelomeningocele. Although endoscopic third ventriculostomy (ETV) is currently considered the preferred treatment for obstructive hydrocephalus, its results have been inconsistent in patients with myelomeningocele. This study focuses on clinical and radiologic outcomes of ETV in children with hydrocephalus related to myelomeningocele. ⋯ ETV can be performed in patients with myelomeningocele and hydrocephalus with success rates of almost 50%. Prior VPS or VPS malfunction or infection do not contraindicate ETV. If possible, the procedure should be delayed until the patient is at least 1 month old.
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The authors describe the application of a new exoscope that offers 3-dimensional (3D) visualization in cranial and spinal neurosurgery in detail. ⋯ The 3D-exoscopic system is safe and effective tool to perform spinal procedures and less demanding cranial procedures. The image quality and 3D visualization were comparable with the operating microscope. The technique harbors the unique advantage of excellent comfort for the involved surgical team during the procedure.
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Incidence of intraprocedural rupture (IPR) during endovascular coiling is reported to be 2%-5%. We reviewed a single-center experience of IPR during coil embolization of unruptured intracranial aneurysms. ⋯ Incidence of IPR during endovascular coiling of unruptured aneurysms is relatively low. Early detection followed by rapid occlusion of the aneurysm can lead to a benign clinical course in most cases.
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Case Reports
A case of laterally extended high-positioned chordoma treated using the high cervical retropharyngeal approach.
Several surgical approaches for the treatment of pathologies of the craniovertebral junction (CVJ) and high cervical regions have been reported. For the best postoperative results, selection of a surgical route to treat such pathologies should be based on a complete understanding of the approach. ⋯ Our results indicate that the high cervical retropharyngeal approach is a reasonable option for pathologies located in the anterior or anterolateral portions of high cervical regions. This approach is an alternative to the transoral approach to the ventral CVJ and high cervical regions.
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Case Reports
Concomitant lumbosacral perimedullary arteriovenous fistula and spinal dural arteriovenous fistula: a case report.
Although multifocal spinal arteriovenous malformations (AVMs) have been reported before, the present case is the first case of 2 different types, including 1 perimedullary arteriovenous fistula and 2 spinal dural arteriovenous fistulas of lumbosacral AVMs, coexisting in 1 patient. We also report the use of hybrid techniques in treatment of concomitant lumbosacral spinal AVMs. ⋯ Multifocal spinal vascular malformations may coexist in 1 case, and standardized spinal digital subtraction angiography, including the bilateral internal iliac arteries and median sacral artery, should be performed to avoid a missed diagnosis. The concomitant phenomenon indicates that venous hypertension may be a risk factor for the development of arteriovenous fistulas. Hybrid techniques are effective in treatment of multifocal and complex spinal AVMs.