World Neurosurg
-
Case Reports
Recurrent Acute Subdural Hematoma Due to Middle Meningeal Artery Bleeding Treated by Embolization.
Recurrent acute subdural hematomas (ASDHs) are a common complication of neurosurgical operations. However, ASDHs associated with middle meningeal artery (MMA) injury are extremely rare. We encountered a rare case of recurrent ASDH due to MMA bleeding after craniotomy for a nontraumatic ASDH and successfully performed MMA embolization for treatment of it. ⋯ In our case, the relationship between the recurrent ASDH and MMA was observed via angiography and MMA embolization was successfully performed to avoid surgery for reevacuation, suggesting that active bleeding of MMA may be a cause of recurrent ASDH after neurosurgical operations and endovascular exploration, and possible treatment is necessary for an unexplained ASDH.
-
To present an attainable and realistic model for neuroendoscopic simulation which replicates exercises of tissue biopsy and coagulation and membrane fenestration. ⋯ Simulators for neuroendoscopy described so far are reliable, but they entail a high cost. Models with live animals, although of lower cost, are questioned from an ethical point of view. In the current work, we describe a high fidelity ventricular neuroendoscopic simulator model that, because of its low cost, can be replicated in any training center that has a neuroendoscope.
-
Surgical closed suction drain (SCSDs) are used in a variety of surgical disciplines to prevent postoperative fluid collections. Use of SCSDs has not been well studied in the neurosurgical literature. Practice patterns have varied within our institution with respect to SCSDs after craniotomies for neurotrauma. In this study we describe SCSD use for patients undergoing evacuation of supratentorial epidural hematomas (EDHs) and examine the effect on patient outcomes and length of hospital stay. ⋯ Use of fewer SCSDs did not affect radiographic outcome after evacuation of epidural hematomas but was associated with decreased intensive care unit length of stay.
-
Comparative Study
A comparative study between traditional microscopic surgeries and endoscopic endonasal surgery for skull base chordomas.
Skull base chordomas (SBCs) are rare clinically aggressive neoplasms, developing local recurrences after surgical resection. Although SBCs have traditionally been resected by craniotomy or microscopic transsphenoidal surgery (TSS), the recent development of the endoscopic endonasal approach (EEA) has revolutionized treatment strategies through minimally invasive techniques. This study aimed to evaluate clinical outcomes after traditional microsurgeries or EEAs for SBCs. ⋯ EEA is a less invasive surgical approach for SBCs. The development of surgical instruments and postoperative radiotherapy will further improve patients' outcomes.