World Neurosurg
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The extreme lateral infrajugular transcondylar-transtubercular exposure (ELITE) is a surgical approach developed in the late 1980s by Prof. T. Fukushima and represents the dorsolateral inferior skull base procedure of choice to approach lesion located ventrolaterally at the level of the craniocervical junction (CCJ). ⋯ This operative video illustrates step-by-step the surgical technique adopted for the microsurgical resection of a C1-C2 intradural schwannoma located antero-laterally (Video 1). ELITE approach offers a wide and adequate exposure and access to the CCJ, allowing direct visualization and access to the tumor with minimal neural manipulations, early detection of the vertebral artery and, for tumor located at C1-C2 level, without drilling the occipital condyle. In our experience, ELITE procedure is the preferred surgical approach for resection of tumors located ventrally or ventrolaterally to the first 2 cervical levels.
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The Arab world is lagging behind in the world of publications and research, especially in the biomedical-related field. This is a bibliometric analysis that aims to assess the neurosurgical research productivity across different Arab countries. ⋯ The results reached by this study reflect an undoubtable need for more research on neurosurgery by Arab countries. This goes back to the different obstacles facing Arab countries every day, affecting the economic, educational, and health care systems.
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Case Reports
Subtemporal-Transtentorial Approach for Microsurgical Resection of Hemorrhagic Ambient Cistern AVM.
Arteriovenous malformations (AVMs) of the ambient cistern are an extremely rare and complex subgroup of vascular malformation, representing a clinical challenge due to the deep-seated, highly eloquent anatomic location and the debilitating, life-threatening consequences related to hemorrhagic presentation and surgical morbidity. Ultimately, a tailored treatment, based on the presenting symptoms, AVM angioarchitecture, and annual risk of hemorrhage should be discussed among a multidisciplinary team to find the best individualized strategy balancing between the pros and cons of each approach. In Video 1, we present the case of a 60-year-old man with a hemorrhaged AVM of the right ambient cistern, present the pros and cons of each possible treatment strategy, and illustrate the successful resection of this lesion through a subtemporal-transtentorial microsurgical approach.
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An anterior approach is applied to establish the majority of rabbit intervertebral disc degeneration (IDD) models in current studies. However, for research on disc repair via biomaterial implantation and tissue engineering, this traditional model establishment method has many shortcomings, such as the risk of general anesthesia, unnecessary tissue damage, and the influence of scar formation on the visual field for secondary implantation surgery. The aim of this study was to report a modified method of establishing an IDD model by applying percutaneous posterolateral puncturing for rabbit lumbar disc surgery under local anesthesia. ⋯ Our results show that percutaneous posterolateral AFP/NPA of rabbit lumbar discs under local anesthesia is a minimally invasive, safe and reproducible method of establishing an IDD model. The posterolateral surgical approach is especially suitable for disc regeneration studies that require secondary biomaterial implantation via an anterior approach after the IDD model is established.
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Although previous studies have made significant contributions to establishing animal traumatic brain injury (TBI) models for simulation of human TBI, the accuracy, controllability, and modeling efficiency of animal TBI models need to be further improved. This study established a novel high-efficiency graded mouse TBI model induced by shock wave. ⋯ The novel TBI apparatus has advantages in its small size, simple operation, high repeatability, high efficiency, and graded severity. Our TBI apparatus provides a novel tool to investigate the neuropathologic changes and underlying mechanisms of TBI with various levels of severities.