World Neurosurg
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We created a neck trauma model by injecting blood into the sheath of rabbits' carotid bodies (CBs). Then we determined the relationship between neuronal degeneration of the CB due to hemorrhage of this organ and its clinical effects such as blood pH and heart rhythm. ⋯ A high degenerate neuron density in the CB can decrease blood pH and hearth rhythm after neck trauma, and there might be a close relationship between the number of degenerated neurons and clinical findings (such as heart rhythm and blood pH). This relationship suggests that injury to the glossopharyngeal nerve-CB network can cause acidosis by disturbing the breathing-circulating reflex and results in respiratory acidosis.
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The aim of this study was to analyze practice trends in specific intracranial bypass types in a large, consecutive bypass experience. ⋯ Intracranial bypass remains an essential technique for open vascular neurosurgeons. The classic low-flow EC-IC bypasses, intracranial-to-intracranial, and combination bypasses increased over time, whereas the high-flow EC-IC interpositional bypasses decreased over time. These trends reflect the increasing use of flow diverters as well as the need for surgical revascularization for complex aneurysms, and those that failed previous endovascular therapy.
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During dissection of paraspinal muscles in posterior surgical approaches, the spine surgeon usually holds a subperiosteal (Cobb) elevator in 1 hand and a monopolar cautery in the other hand. In such a scenario, both the surgical smoke generated by the monopolar and eventual bleeding constitute a significant hindrance to simultaneous bilateral dissection of the paraspinal muscles by 2 surgeons. ⋯ We present what we believe is the first description of a new coupled Cobb-suction instrument that has been developed to enable simultaneous retraction and suction with 1 hand, while allowing the spine surgeon to use the monopolar cautery with the other hand. In our preliminary institutional experience, this new tool has been proven to be especially useful in long posterior spinal approaches in the thoracolumbar region.
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Despite the fact that technologic advances and surgical experience expand the use of endoscope in spinal surgery, there are few reports on its application in the management of spinal tumors. We present a case report of intradural extramedullary tumor excision with the percutaneous full endoscopic translaminar approach. ⋯ This report supports that full endoscopic spinal intradural extramedullary mass excision may give good results in selected cases and in experienced hands.
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The relationship between superior cervical ganglia (SCG) ischemia due to bilateral common carotid artery ligation (BCCAL) and basilar artery (BA) reconfiguration was investigated. ⋯ A meaningful and paradoxic correlation was detected between the BA VDI values and degenerated neuron density of SCG after BCCAL. Although a low degenerated neuron density within SCG may provoke excessive sympathetic activity and prevent excessive BA dilatation with steno-occlusive carotid artery diseases, a high degenerated neuron density may cause dangerous vasodilatation of BA.