World Neurosurg
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Review Case Reports
Coarctation of the Aorta Complicated with Intracranial Aneurysm: A Case Report and Literature Review.
Coarctation of the aorta (CoA) complicated with rupture and hemorrhage of intracranial aneurysms is not commonly seen in clinical practice. Here we report a middle-aged female patient who presented with acute severe headache. ⋯ The pathophysiological mechanism of CoA complicated with intracranial aneurysm remains unclear, but attention should be given to the relationship between the 2 entities in clinical practice, and effective treatment should be provided according to specific conditions.
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Rhabdoid meningioma (RM) and papillary meningioma (PM) are rare variants of World Health Organization grade III meningiomas. In this study, we presented a series of 23 cases from our institution to investigate adverse factors of and appropriate treatment for RM and PM. ⋯ We recommended adjuvant radiation regardless of the extent of resection. Individuals with PM or RM were at increased risk of recurrence and death; appropriate treatment for these patients should be further studied, and close follow-up is needed.
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To optimize follow-up and surveillance routines after intracranial surgery, knowledge about when complications occur is needed. We sought to explore when postoperative complications are detected after brain tumor surgery and assess their severity. ⋯ Mild and moderate complications, dominated by extracranial infections such as urinary tract infections and pneumonias, are very common after intracranial tumor surgery. Detection rates for mild and moderate complications are probably greatly affected by local routines for surveillance, screening, discharge, documentation, and follow-up, perhaps limiting their usefulness as a quality measure. Severe and fatal complications are mainly detected in the early postoperative course.
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Review Case Reports
Median Supraorbital Keyhole Approach for Clipping Ruptured Distal Anterior Cerebral Artery Aneurysm: Technical Report with Review of Literature.
The minimally invasive approach to distal anterior cerebral artery (DACA) aneurysms has not gained much acceptance due to difficulties associated with the conventional frontal paramedian approach. The more proximal basal interhemispheric approach, however, necessitates extensive dissection of soft tissues. We describe a novel minimally invasive median supraorbital keyhole craniotomy with a basal interhemispheric approach for clipping a ruptured DACA aneurysm. ⋯ The median supraorbital keyhole approach is a minimally invasive technique sufficient for clipping most DACA aneurysms, with easier access, better proximal control, and good cosmesis.
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Case Reports
Acute Compartment Syndrome as a Complication of the Use of Intraoperative Neuromonitoring Needle Electrodes.
The use of intraoperative neurophysiologic monitoring (IOM) has become commonplace in many neurosurgical procedures as a tool to reduce the risk of complications through the early identification of reversible neurologic compromise. Although complications related to IOM itself are exceedingly rare, recognizing their clinical presentation in the postoperative neurosurgical patient is essential for the early identification and implementation of appropriate treatment. ⋯ This case represents the first report of post-procedural compartment syndrome resulting from placement of neuromonitoring needles for routine IOM. Although it is a particularly rare complication of IOM, compartment syndrome represents a surgical emergency that carries significant morbidity if not immediately recognized and treated.