World Neurosurg
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Irregular shape is a known risk factor of intracranial aneurysm rupture causing subarachnoid hemorrhage. The objective of this study was to determine the impact of aneurysm shape on intraoperative rupture (IOR) during microsurgical clipping of ruptured aneurysms. ⋯ Our results demonstrate that IRA shape is an independent risk factor for IOR. In the analyzed patient cohort, aneurysm shape and IOR had no significant impact on patient prognosis.
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The surgical approach for the trigeminal nerve involves veins connected to the superior petrosal and tentorial sinus, and we should pay special attention to these veins. We investigated intraoperative and postoperative bleeding using our database. ⋯ Microvascular decompression for trigeminal neuralgia involves potential risks of intraoperative and postoperative bleeding.
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Microvascular decompression for hemifacial spasm is performed at the root exit zone. More proximal segments of the facial nerve, defined as the root emerging zone (REmZ), may also be susceptible to neurovascular compression. Consequently, detailed knowledge of the microanatomy around facial nerve fibers at the pontomedullary junction is essential for consistent success of microvascular decompression. ⋯ Facial nerve fibers are susceptible to vascular compression on emerging onto the deep brainstem surface at the pontomedullary sulcus. The key procedure in microvascular decompression is full dissection of the lower cranial nerves down to the brainstem origin to explore both the root exit zone and the REmZ.
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Neuroglial cysts (also known as glioependymal cysts) are rare, benign, epithelial-lined cystic lesions that can potentially occur anywhere in the neuraxis. They can be intra, or within, a cranial nerve with the former being more common. The frontal lobe is thought to be the most common location. ⋯ The keyhole supraorbital approach was selected to provide a direct route to the pathology with minimal soft tissue disruption. The patient was discharged on postoperative day 2 without any complications. Follow-up at 6 weeks demonstrated near-complete resolution of her quadrantanopsia and good cosmesis with no frontalis palsy.
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To trace anatomic variations of the lateral femoral cutaneous nerve (LFCN) in its intrapelvic course. ⋯ Considerable variability in the origin and the course of the LFCN was observed, which should be taken into account during clinical assessment of nerve lesions and during surgery via transpsoas approaches to the lumbar spine.