World Neurosurg
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Dura of the anterior clinoid process (ACP) is presumably supplied by the ophthalmic and external carotid artery branches. There is a less recognized artery described by Yasargil that arises directly from the supraclinoid internal carotid artery (ICA) and supplies the ACP dura. We studied the origin and course of this direct branch in patients in whom the carotid cistern was dissected for lesions not involving the carotid cistern and ACP dura. The management implications of this arterial twig have been described. ⋯ The knowledge of this arterial twig to the clinoidal dura is important as this supply may be responsible for feeding the tumor arising from the dura arising from the anterior clinoid, making preoperative embolization impossible. In addition, the tumor may grow along with this vessel and infiltrate the adventitia of the ICA at the origin of this vessel.
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To investigate changes of oblique corridor in patients with lumbar degenerative scoliosis and determine proper working angle with respect to the direction of vertebral axial rotation during the oblique lumbar interbody fusion procedure. ⋯ In the left apex group, the oblique corridor was decreased from psoas overlap, and coupled axial rotation to the left side might increase the risk of contralateral nerve root injury during orthogonally working. Thus, surgeons should pay attention to the state of coupled vertebral axial rotation of lumbar degenerative scoliosis for the oblique lumbar interbody fusion procedure.
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Flow diversion for treatment of intracranial aneurysms frequently necessitates covering adjacent branch vessels. Although branch vessel occlusion is common, associated clinical deficits are rare. It has been hypothesized that clinically silent branch vessel occlusion is due to underlying collateral circulation. To study the role of collateral circulation in covered branch vessel occlusion, we assessed collateral vessels and altered branch vessel flow on transfemoral catheter angiography in patients undergoing flow diversion of intracranial aneurysms. ⋯ Altered flow in branch vessels covered during flow diversion reflects underlying collateral circulation and is not associated with downstream ischemic deficits.
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The present retrospective study evaluated the clinical results of full-endoscopic lumbar discectomy (FELD) for the treatment of lumbar disc herniation (LDH) with lumbar posterior ring apophysis fracture (PRAF) using an interlaminar or a transforaminal approach at an inpatient surgery center. ⋯ FELD is a safe and effective minimally invasive approach for the treatment of LDH with type III PRAF. Sufficient preparation and experience are required to achieve satisfactory results.
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The safety and efficacy of brain parenchyma biopsy during minimally invasive (MIS) intracerebral hemorrhage (ICH) clot evacuation has not been previously reported. The objective of this study was to establish the safety and diagnostic efficacy of brain biopsy during MIS ICH clot evacuation and to validate the modified Boston criteria as a predictor of cerebral amyloid angiopathy (CAA) in this cohort. ⋯ Brain biopsy in MIS ICH clot evacuation is safe and allows for the diagnosis of various ICH etiologies.