World Neurosurg
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Various complications that can occur during and after cranial surgery have been investigated extensively. One of the less frequent complications has thus far received little attention, however: displacement of the skull implant after craniotomy or craniectomy. The purpose of this study is to identify prognostic factors for the development of skull implant displacement (SID). ⋯ A notable number of SIDs only occur after CPs that follow a DC. An advantage in successful placement was observed when fixation of the skull implant during cranioplasty was performed using miniplates.
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Ventricular shunts are most commonly placed via a frontal or parietal approach. However, there is a paucity of data comparing complication and revision rates associated with these approaches in the idiopathic normal pressure hydrocephalus (iNPH) population. ⋯ These results suggest that the type of approach for shunting may not have a significant impact on complication and revision rates in patients with iNPH, and either approach is a reasonable first-line option.
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There have been a few previous reports of trigeminal neuralgia caused by bony structures. We report a rare case of trigeminal neuralgia caused by petrous bone deformity. ⋯ The anterior transpetrosal approach is an appropriate and essential strategy for trigeminal neuralgia caused by petrous bone deformity of the petrous apex.
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Hemispherectomy is a successful and well-described treatment option for pediatric patients with hemispheric ictal onset, but adult outcomes have been far less studied. We describe the outcomes in adult patients with medically refractory epilepsy and hemispheric disease and the relationship to cerebral peduncle volume. ⋯ These findings suggest that smaller ipsilateral cerebral peduncle size could potentially be associated with unchanged postoperative hemiparesis. We hypothesize that smaller ipsilateral peduncle size could have represented corticospinal tract reorganization in childhood, implying that the removed brain matter was mostly noncontributory to contralateral motor function.
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The parieto-occipital artery (PoA) is the terminal posterior cerebral artery branch, which typically runs in the parieto-occipital sulcus. Previous studies have highlighted variation in the PoA origin and branching pattern and their clinical implications. Nevertheless, PoA anastomoses have not been systematically investigated. The present study aimed to assess whether putative variation in PoA origin and its branching as well as anastomotic pattern is associated with differences in demographic/anthropometric variables. ⋯ Although the PoA invariably supplies the precuneus and almost always the cuneus, its direct contribution to the former seems inferior to PAc. Nevertheless, the PoA frequently shows putative collateral supply networks to the precuneus and cuneus via anastomoses with the PAc and calcarine artery, respectively. The distance between PoA origin and OP varies with an individual's height; the frequency of intrahemispheric PoA anastomoses varies with its site of origin.