World Neurosurg
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A 9-French (Fr) sheath is routinely used during mechanical thrombectomy (MT) for treating acute ischemic stroke (AIS). However, the use of a large sheath is a risk factor for access site complications (ASCs). Previous studies focused on preventing intracranial complications, and only a few have explored ASCs. We investigated the technical feasibility and efficacy of a sheathless procedure for AIS (SPAIS) that uses a 9-Fr balloon-guiding catheter as a guiding sheath to reduce the sheath size and prevent ASCs during MT. ⋯ SPAIS is a feasible technique that effectively reduces MT-associated ASCs; thus, this approach should be adopted to improve patient outcomes.
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To investigate the effect of deep brain stimulation (DBS) on rats with spinal cord injury (SCI) and its possible molecular mechanism. ⋯ DBS improves motor function in rats with SCI by increasing synaptic plasticity via tropomyosin-related kinase B-protein kinase B-mammalian target of rapamycin pathway.
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An elderly woman was transferred for biopsy of a pontine lesion. Her condition, including gait disturbances, truncal ataxia, and dysarthria-presumed to be due to severe alcohol abuse-had deteriorated during treatment of ambulatory-acquired pneumonia. ⋯ Although extremely rare, pontine myelinolysis can occur in the presence of normal electrolyte levels. Thus, imaging findings should not be misinterpreted as pontine neoplasms, and patients should not undergo stereotactic biopsy-a procedure that could result in disastrous morbidity.
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Endoscopic third ventriculostomy (ETV) is a widely accepted treatment for obstructive hydrocephalus. For most practitioners, this procedure will be performed without navigation guidance. Without such guidance, the complications associated with the procedure have ranged from 1% to 8%. We hypothesized that the discrepancy between the surface bony anatomy and internal cranial anatomy contributes to the morbidities associated with ETV. We tested this hypothesis by comparing the position of the entry point defined by the classic Kocher's point relative to the ideal entry point that would result in no manipulation of the endoscope defined by frame-based stereotaxis. ⋯ The use of stereotactic endoscopic techniques increase the safety of third ventriculostomy by adding precision and reducing otherwise unnecessary surgical maneuvering.