World Neurosurg
-
Keyhole craniotomy is a type of pterional craniotomy that involves a minimally invasive approach for the treatment of cerebral aneurysms. Currently, the minipterional keyhole craniotomy and supraorbital keyhole craniotomy procedures are frequently performed. ⋯ The success solely depends on careful selection of patients and the experience of the surgical team.
-
Bilateral trigeminal neuralgia is a relatively rare disease. Microvascular decompression (MVD) is a safe and effective treatment for unilateral trigeminal neuralgia; however, its utility in bilateral trigeminal neuralgia is unclear. Here, we report our experience with MVD in 13 cases of primary bilateral trigeminal neuralgia. ⋯ Vascular compression plays a causative role in bilateral and unilateral trigeminal neuralgia. MVD appears to be a safe and effective treatment option in patients who are refractory to pharmacotherapy.
-
To present an algorithm based on clinical and radiologic factors, including magnetic resonance imaging (MRI) perfusion/diffusion mismatch (PDM), for the indication of urgent cerebral bypass in patients with acute ischemic stroke. ⋯ Based on an algorithm indicating salvageable brain tissue, cerebral revascularization can be safely performed in an emergency setting in a highly selected group of patients with acute ischemic stroke with favorable clinical outcome.
-
Anterior transthoracic approaches, including thoracoscopic microdiscectomy (TMD), are the preferred techniques for central, broad-based, calcified thoracic disc herniations (TDHs). Dural defects due to manipulation or transdural extension may create a potentially life-threatening subarachnoid-pleural fistula. We evaluate a fast, sutureless technique for reconstructing the dura. ⋯ Dural defects encountered during anterior transthoracic approaches to TDHs can be reconstructed endoscopically, while avoiding the use of an ELD in most cases.