World Neurosurg
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Observational Study
Lower Iron Levels Predict Acute Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage.
We tested the hypothesis that low serum iron levels are associated with acute hydrocephalus following aneurysmal subarachnoid hemorrhage (aSAH). ⋯ Lower serum iron levels after aSAH was a predictor of acute hydrocephalus and unfavorable outcome.
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Tandem cervical carotid and intracranial occlusions are a well-known cause of complicated endovascular thrombectomy (EVT) in acute ischemic stroke. We aimed to evaluate safety and efficacy of an anterograde approach, which involved carotid balloon angioplasty (BA) alone without carotid artery stenting (CAS) followed by intracranial target recanalization (TR). ⋯ EVT for tandem cervical carotid and intracranial occlusions showed optimistic results in terms of clinical and angiographic outcome. The anterograde EVT strategy of cervical BA alone then intracranial TR was effective in 85.5% of patients, which was likely to reduce PT to target recanalization.
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Bypass surgery is a special technique used to treat complex internal carotid artery (ICA) aneurysms. The aim of this retrospective study is to provide a comprehensive description of treatment and outcome of complex ICA aneurysms at different ICA segments (cavernous, supraclinoid, ICA bifurcation) treated with bypass procedures. ⋯ Bypass surgery for complex ICA aneurysms is a feasible treatment method with an acceptable risk profile. Patients should be informed of the uncertainty related to improvement of pretreatment cranial nerve dysfunctions.
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Case Reports
Second sacral alar screw fixation: anatomic study of three dimensional computed tomography and case report.
S2 alar screw would be an alternative choice without breaking the sacroiliac joint. The aim of this study was to measure radiographic parameters for optimal placement of posterior S2 alar screw for instrumentation and fusion. ⋯ S2 alar screw is an alternative sacral fixation point to provide additional biomechanical stability of lumbosacral constructs. A trajectory with maximum length through the S2 ala can be determined using three-dimensional computed tomography.
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Levodopa has long been the standard of care for Parkinson disease (PD); however, the eventual onset of motor fluctuations and levodopa-induced dyskinesia (LID) complicates its utility in advanced PD. Current neurosurgical interventions remain some of the best options for LID. Deep brain stimulation (DBS) is currently the procedure of choice for patients with advanced PD, patients refractory to medical management, and patients with motor complications from levodopa therapy. ⋯ Transcranial magnetic stimulation, which can induce local and distant effects in cortical and subcortical areas, has shown efficacy in managing certain PD and LID symptoms in early studies. Finally, direct stimulation of the motor cortex and the cerebellum has shown therapeutic effects in PD and LID patients in certain studies. Taken together, many of these new techniques have shown great promise in early studies and may eventually be preferred treatment options for LID patients.