World Neurosurg
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Transsphenoidal surgical approaches involve dissection of the posterior wall of the sphenoid sinus in close proximity to the internal carotid arteries. To reduce the risk of vascular injury, a detailed study of embalmed cadavers' sellae was conducted and found the internal carotid artery approached within 4 mm of the midline in 10% of cases, and the closest intercarotid distance (ICD) occurred in the cavernous sinus, sphenoid sinus, and supraclinoid segments in 82%, 14%, and 4% of cases, respectively. These measurements have not previously been compared with living patients with modern imaging techniques. ⋯ Surgically relevant measurements of the carotid arteries in the sellar are different in cadavers and living subjects. This is likely due to postmortem changes of surrounding structures. This study suggests clinically relevant anatomic studies using measurements taken from cadaveric specimens be updated with modern imaging techniques taken from living patients.
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Case Reports
Ruptured persistent trigeminal artery-basilar artery junction aneurysm: a case report and review of literature.
The persistent trigeminal artery is the most common type of persistent fetal carotid-basilar anastomosis. Patients who are found to have a persistent trigeminal artery are more likely to harbor intracranial aneurysms, both along the persistent trigeminal artery and elsewhere in the cerebral vasculature. ⋯ Although several variations of the persistent trigeminal artery describe blood flow from the internal carotid to the posterior circulation, this is the first case to describe a persistent trigeminal artery that is the primary supply of the internal carotid artery due to an absent common carotid artery. Successful treatment of aneurysms of the persistent trigeminal artery may require occlusion of the artery.
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A questionnaire to assess the challenges faced by women who quit working as full-time neurosurgeons.
To analyze why women quit full-time employment as neurosurgeons and to discuss the conditions required for their reinstatement. ⋯ The Japan Neurosurgical Society could facilitate supportive environments for women in neurosurgery by enhancing adequate childcare services, changing the work style of full-time neurosurgeons to incorporate diverse working styles, shorter working hours, understanding of their bosses and colleagues, and a career counseling system.
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Neurosurgical micropatties (also known as sponges or cottonoids) have been used in microsurgical procedures to protect the brain surface and aspirate cerebrospinal fluid and blood. We sought to describe unique applications of micropatties in neurosurgical interventions. ⋯ To achieve safe and successful neurovascular protective surgery, micropatties play an important role in any type of microsurgical procedure in their various applications.