World Neurosurg
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Aneurysms originating from the distal portion of the lenticulostriate artery (LSA) are uncommon. Distal medial LSA (MLSA) aneurysms are particularly uncommon when compared with distal lateral LSA aneurysms, and their clinical features are unclear. Here, we present 2 patients with aneurysms of the distal MLSA who exhibited hemorrhages of the caudate nucleus and intraventricular region (intraventricular hemorrhage [IVH]). ⋯ We should consider the possibility of a ruptured distal MLSA aneurysm when diagnosing a patient with IVH-with or without a caudate nucleus hematoma. Repeated imaging evaluations may be necessary to find the lesion.
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Small cell neuroendocrine carcinoma of the Bartholin gland is an extremely uncommon gynecologic tumor. Brain metastasis from a malignant gynecologic lesion is rarely encountered and the prognosis for this type of metastasis is quite poor. ⋯ Different treatment options, including resection, stereotactic radiosurgery, and whole-brain radiation therapy, as well as chemotherapy, are available and should each be considered on an individual basis.
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Case Reports
Completion corpus callosotomy with stereotactic radiosurgery for drug-resistant, intractable epilepsy: Case report.
Stereotactic radiosurgery (SRS) offers a noninvasive technique for division of the corpus callosum, which can confer improved seizure control to patients suffering from frequent atonic seizures due to rapid interhemispheric generalization. This noninvasive approach is well-suited for use in a palliative intervention for improved seizure control in this patient population. To our knowledge, this is the first report of radiosurgical completion corpus callosotomy in an adult in the United States. ⋯ Eight months postradiosurgical corpus callosotomy, the patient is free of atonic seizures and is ambulatory. In carefully selected cases and with protective radiosurgical planning, SRS for completion corpus callosotomy represents an effective option for refractory seizure control.
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Spinal arteriovenous fistulas have abnormal connections between spinal arteries and veins. Early diagnosis and management are essential for preventing permanent neurologic deficits. Although symptoms of myelopathy are commonly related to established types of spinal arteriovenous fistulas within the spine, extraspinal arteriovenous anomalies may also result in similar pathology and pose challenges to conventional endovascular treatment. ⋯ Extraspinal vascular malformations with vascular myelopathy are extremely rare. They include a broad spectrum of complex vascular disorders and often require alternate endovascular approaches.
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Home programme for acquisition and maintenance of Microsurgical Skills during the Covid-19 Outbreak.
During the current global crisis unleashed by the severe acute respiratory syndrome coronavirus 2 outbreak, surgical departments have considerably reduced the amount of elective surgeries. This decrease leads to less time in the surgical room to develop and improve the surgical skills of residents. In this study, we developed a training program to obtain and maintain microsurgical skills at home, using a smartphone camera and low-cost materials, affordable for everyone. ⋯ We developed a microsurgical skills training program to be performed at home, which can be easily reproduced. It allows residents to improve manual coordination skills and is regarded as a feasible adjunct for ongoing training for surgical residents.