World Neurosurg
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Tumors extending into the optic canal can cause progressive visual impairment because of optic nerve compression. Prompt surgical resection is often necessary. When the tumor is located medially in the optic canal, endoscopic transnasal surgery provides a safer, less invasive alternative to a transcranial approach. ⋯ Endoscopic transnasal surgery is a valuable option for aggressive lesions in the optic canal. Although the efficacy of radiotherapy for solitary fibrous tumor remains controversial, it should be considered when the tumor shows progressive features.
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Retracted Publication
Inpatient Outcomes After Elective Lumbar Spinal Fusion for Patients with Human Immunodeficiency Virus in the Absence of Acquired Immunodeficiency Syndrome.
To our knowledge, no prior study has evaluated outcomes after elective lumbar spinal surgery in human immunodeficiency virus (HIV) patients without acquired immunodeficiency syndrome (AIDS). This review investigated the impact of HIV-positive status (without AIDS) on outcomes after elective lumbar fusion for degenerative disc disease (DDD). ⋯ Even in this selected cohort of well-controlled HIV patients, there were high complications, with concerning rates of death and respiratory complications. These data shed new light on elective spine surgery in HIV patients and may influence the treatment algorithm of surgeons who are familiar with older papers.
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Case Reports
Disconnection Surgery for Intractable Epilepsy with a Structural Abnormality in the Medial Posterior Cortex.
The lesionectomy is a general surgical procedure for treating focal epilepsy resulting from a structural abnormality, but a favorable outcome cannot be achieved in some patients, especially patients whose symptomatogenic zone is located in remote regions. Herein we propose the surgical disconnection of the seizure propagation pathway, which consists of short and long associating fibers linking the epileptogenic zone to the remote symptomatogenic zone, as an effective method of achieving favorable seizure outcomes in patients with posterior cortex epilepsy. ⋯ The current study suggested that assuming the presence of association fibers was an important factor for achieving a favorable outcome in the surgical treatment of posterior cortex epilepsy. Though further study is required, disconnection surgery is recommended as a treatment option for cases in which the epileptogenic zone is located in an eloquent area.
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To explore the value of the application of neuroendoscopy techniques in the treatment of ventriculoperitoneal (VP) shunt blockage. ⋯ Neuroendoscopy techniques can be used to reveal the various causes of shunt obstruction. Any attempt to extract the tube should be performed with the aid of a neuroendoscope. The 3 surgical revision strategies for a blocked catheter are described for the first time in the literature. These approaches can reduce the operation time, the incidence of intraventricular hemorrhage, and the risk of infection.
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The development of stereotaxy can be dated back 100 years. However, most stereotactic neurosurgery still relies on the workflow established about half a century ago. With the arrival of computer-assisted navigation, numerous studies to improve the neurosurgical technique have been reported, leading to frameless and magnetic resonance imaging (MRI)-guided/verified techniques. ⋯ Clinical benefits have been shown in the recent surge of robot-assisted surgical interventions. We review the state-of-the-art intraoperative MRI-guided robotic platforms for stereotactic neurosurgery. To improve the surgical workflow and achieve greater clinical penetration, 3 key enabling techniques are proposed with emphasis on their current status, limitations, and future trends.