World Neurosurg
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The first aim of this study is to bring up the radiological and surgical difficulties of kissing aneurysms and to present solutions. The second aim is to develop a classification that can help to predict the difficulties encountered during surgery. ⋯ Despite advanced angiographic techniques, even today, kissing aneurysms can be misinterpreted as a single bilobular aneurysm. The ruptured aneurysm may not be detectable preoperatively. These complex aneurysms have a high intraoperative rupture risk. Accompanying vascular anomalies are more common than expected. Clip selection and sequencing are important. Proposed classification helps the surgeon to be aware of intraoperative difficulties that he/she may encounter in advance.
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The continuous development of microsurgical techniques to treat lesions in and around the optic canal (OC) emphasizes the need for an accurate understanding of the microanatomy of the region. ⋯ The neurovascular structures within the OC vary in size and shape. The anatomic knowledge of the OC and its variations allows better surgical results and minimizes the surgical morbidity.
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Cortical spreading depolarization (CSD), cortical spreading ischemia (CSI), and early brain injury are involved in the occurrence of delayed brain ischemia after subarachnoid hemorrhage (SAH). We tested whether local application of magnesium (Mg) sulfate solution suppressed CSD and CSI, and decreased brain damage in a rat SAH-mimicking model. ⋯ Local application of Mg suppressed CSI and reduced brain damage in a rat SAH-mimicking model. Mg irrigation therapy may be beneficial to suppress brain damage due to CSI after SAH.
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Spinal surgeries are the leading causes for patient settlement issues. Recent European Medical Device Regulations aims to reduce complications by enforcing that surgical tools are validated before clinical use. Human cadavers are favored in preclinical use, but due to anatomic variance, decay, and scarce supply, alternative synthetic and animal models are used. This study evaluates the fidelity and validity of porcine models in training and assessment of microsurgical decompressive techniques in the lumbar spine. ⋯ Pigs are representative for assessing microsurgical decompression techniques in the lower lumbar spine. The novel "en bloc" pig model can be an asset for industries and clinicians during assessment and training of new spinal techniques.