World Neurosurg
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There is no consensus concerning the management of adult patients with posterior fossa metastasis-associated obstructive hydrocephalus, especially regarding surgical procedures. A literature review was performed to assess the surgical strategy in the management of patients with metastatic brain tumor. ⋯ The Neuro-oncology Club of the French Society of Neurosurgery suggests a prospective assessment of these neurosurgical procedures to compare their safety and efficacy.
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Surgical resection of parasellar meningiomas is a challenging operation that traditionally has been performed with a large pterional or orbitozygomatic craniotomy. In this study, we report patient outcomes and detail our surgical approach when resecting these tumors with a smaller, less invasive "mini-pterional" craniotomy. ⋯ The mini-pterional craniotomy can be used to resect parasellar meningiomas with good results and a low complication profile. This approach provides an efficacious method of resecting these tumors without sacrificing Simpson grade or patient safety.
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Multicenter Study
Tailoring Endoscopic Approach to Colloid Cysts of the Third Ventricle: A Multicenter Experience.
Endoscopic removal of third ventricular colloid cysts has grown in popularity. The biggest issues concern radicality, cure or at least long-term control of the disease, and endoscopic remnants. Technologic advances in instrumentation and introduction of novel tools have greatly improved endoscopic results. Deeper knowledge of surrounding anatomy and awareness that colloid cysts vary in their position (foraminal or retroforaminal) can further improve with the selection of a tailored approach for each patient. ⋯ A traditional precoronal transforaminal approach should be considered only for pure foraminal cysts (group A), as the retroforaminal component is poorly controlled. Retroforaminal cysts (groups B and C) should be resected through a retroforaminal transpellucidum interfornicialis route. A supraorbital transforaminal approach is a more versatile approach suitable for most cases.
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The use of microsurgery for aneurysm clipping has decreased considerably in recent years. This study was conducted to demonstrate the safety and effectiveness of surgical treatment of intracranial aneurysms even in less-developed countries. ⋯ Microsurgical treatment of intracranial aneurysms is an effective and safe method.
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The trigeminocardiac reflex (TCR) is characterized by bradycardia, decrease of mean arterial blood pressure, and sometimes, asystole during surgery. We critically reviewed TCR studies and devised a novel classification scheme for assessing the reflex. ⋯ TCR is a critical cardiovascular phenomenon that must be quickly identified and efficiently classified and should trigger vigilance. Prompt therapeutic measures during neurosurgical procedures should be carefully addressed to avoid unwanted complications. Accurate categorization using the new classification scheme will help to improve understanding and guide the management of TCR in the perioperative period.