World Neurosurg
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The middle cluneal nerves (MCNs) are stated to arise from the sacral dorsal rami of S1 to S3 and supply the gluteal skin, but their detailed anatomy is unclear and often variably depicted and described. Therefore, the goal of this study was to revisit the anatomy of the MCNs and provide a clearer picture of their morphology. ⋯ We clarified the anatomy and variations of the MCNs and revisited its current nomenclature. Such knowledge might improve diagnoses and invasive procedure outcomes in patients with pathology in the region of the MCNs.
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Endovascular treatment for unruptured intracranial aneurysms (UIAs) has been regarded as second to none management nowadays as the result of its proven efficacy and need for less-invasive treatment. Most researchers have focused on the anatomical outcome after endovascular treatment, so in this study we estimated the real incidence of untoward effect and degree of patients' satisfaction based on s survey. ⋯ Ninety percent of patients were satisfied with the results after endovascular treatment of UIAs. Endovascular coil embolization was effective and safe procedure, with high clinical success rate and degree of satisfaction.
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We evaluated the tumor control and cranial nerve (CN) outcomes after adjuvant stereotactic radiosurgery (SRS) for petroclival, cavernous sinus, and cerebellopontine angle meningiomas. ⋯ Adjuvant SRS provides effective tumor control and a low rate of new or worsening CN deficits.
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In clipping surgery, it can be advantageous to dissect an adherent artery from the aneurysmal dome to achieve complete clipping. Bypass surgery can be useful to reconstruct an adherent artery when dissection of the artery is technically difficult or risky. We report the effectiveness of tailor-made intracranial (IC)-IC bypass to reconstruct an adherent artery in clipping surgery for middle cerebral artery (MCA) aneurysms. ⋯ During clipping surgery for MCA aneurysms, tailor-made IC-IC bypass is one of the useful options to reconstruct tightly adherent branch arteries, especially when an external carotid artery graft has not been prepared in advance.
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Postoperative C5 palsy affects 8% of patients undergoing posterior cervical decompression. It is associated with a period functional disability that may exceed 12 months and increase direct care costs > $2000. ⋯ Foraminal stenosis most strongly predicted postoperative C5 palsy. A proof-of-concept model incorporating foramen size, as well as clinical complaints of paresthesias, hand clumsiness, and gait abnormality, successfully predicts the occurrence of postoperative palsy with an overall accuracy of 78%.