World Neurosurg
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Pituitary tumors are common, well-described skull base tumors of sellar origin. However, there are reports of rare ectopic pituitary tumors that are found exclusively outside of the sella turcica. Ectopic pituitary tumors have not been holistically analyzed. This study describes presentation and clinical patterns found among patients with ectopic pituitary tumors. ⋯ Ectopic pituitary tumors are a rare entity of pituitary tumors with a presentation that can mimic those of other skull base tumors. Clinical presentation often correlates to location of the tumor. Ectopic pituitary tumors were significantly more likely to be functional secretory tumors. They may also exhibit more aggressive behavior than sellar-located tumors. Ectopic pituitary tumors may be part of a spectrum of presenting pathologies. Further genetic or genomic analysis is necessary to better understand their pathogenesis and clinical presentations.
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Multicenter Study
2-micron Continuous Wave Laser Assisted Neuroendoscopy: Clinical Experience of Two Institutions in 524 Procedures.
To present the clinical experience of 2 neurosurgical centers with the use of a 2-micron continuous-wave laser (2μ-cwL) system as standard tool in neuroendoscopic procedures and to discuss the safety and efficacy of this system. ⋯ This large series of 2μ-cwL as a routine tool in neuroendoscopic procedures demonstrates that 2μ-cwL is safe for endoscopic third ventriculostomy, septostomy, cyst fenestration, and intraventricular tumor biopsy or resection. As a cutting and coagulation tool, it combines the action of mechanical tools like forceps, balloons, and scissors plus those of electric tools. It therefore renders neuroendoscopic procedures more straightforward with a minimum need to change tools.
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Significant progress in hardware and surgical techniques for sacroiliac joint (SIJ) fusion surgeries has facilitated safer and more efficacious procedures for patients. Triangular-shaped implants for SIJ fusions are the most-studied devices and have demonstrated good short-term and long-term clinical outcomes. Reports on cylindrical threaded implants are very limited. Owing to biomechanical differences in the implants and the surgical techniques required for their placement, previously reported results may not be applicable to cylindrical threaded implants. The aim of this study was to report preliminary clinical experience with minimally invasive SIJ fusion using intraoperative stereotactic navigation and the Rialto SI Fusion System. ⋯ Minimally invasive SI joint fusion using cylindrical threaded implants can be safely performed with minimal morbidity and good clinical outcomes.
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Infection is a life-threatening complication of ventriculostomy. The purpose of this quality improvement project was to develop a cost-effective, evidence-based intervention to reduce ventriculostomy-associated infection (VAI) rates. ⋯ The use of AC-Vs in combination with decreased frequency of CSF sampling was cost saving and resulted in a significant reduction in device-related infections.
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Concepts that showed substantial efficacy in animal models of subarachnoid hemorrhage (SAH) often failed to improve outcome in humans with aneurysmal SAH. The concept of "comparative medicine," an open-minded comparison across species, might offer an alternative to the "constructed" animal models' approach. Naturally occurring diseases in animals might bear more similarity to human diseases than models. In this context, the question arises whether spontaneous intracranial aneurysms exist in animals or not, and whether they cause SAH or not. ⋯ Although interesting and innovative, the concept of "comparative medicine" seems to be impracticable due to the seemingly ultralow incidence of natural aneurysmal SAH in mammals other than man. The answer to the question "why intracranial aneurysms are less common in animals despite the strong histological similarity of cerebral arteries" might be a key issue. Last but not least, primates likely matter in SAH-related research, as aneurysmal SAH occurs in primates.