World Neurosurg
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This study aimed to compare the external ventricular drain (EVD) placement accuracy and complication rates, between neuronavigation-guided, ultrasound-guided, and freehand techniques in our single-center cohort, and through an additional meta-analysis of the currently available literature. ⋯ Our results, pooled with those of previous studies, suggest image-guided EVD placement significantly reduced the rate of suboptimally placed EVDs. We conclude in appropriately selected cases that image-guided EVD insertions may improve accuracy of catheter placements and reduce associated complications of the procedure.
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Review
Improvements in Nerve Dissection Surgery Methodology for Spasmodic Torticollis Treatment: a Review.
Spasmodic torticollis is the most common focal dystonia and is characterized by aberrant involuntary contraction of muscles of the neck and shoulders, which greatly affects patients' quality of life. Consequently, patients with this condition often desire treatment to alleviate their symptoms. The common clinical treatments for spasmodic torticollis include interventions such as drug therapy, botulinum toxin injections, and surgery. ⋯ Nerve dissection surgery is the most common surgical treatment for spasmodic torticollis. This article reviews existing research on nerve dissection surgery for the treatment of spasmodic torticollis and the history of its development, along with the advantages and disadvantages of various surgical improvements. This article aims to provide clinicians with practical advice.
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A transition is underway in neurosurgery to perform relatively safe surgeries outpatient, often at ambulatory surgery centers (ASC). We sought to evaluate whether simple intracranial endoscopic procedures such as third ventriculostomy and cyst fenestration can be safely and effectively performed at an ASC, while comparing costs with the hospital. ⋯ Elective endoscopic third ventriculostomy and other simple NE procedures can be safely and effectively performed at an ASC for appropriate patients with significantly reduced cost compared with the hospital.
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Fenestrations of cerebral arteries are congenital variants that develop when primitive vessels fuse incompletely. An association between the incidence of aneurysm and a fenestrated artery has been noted in the radiological literature. However, technical limitations of radiological studies may hamper visualization of small fenestrations and aneurysms. We sought to analyze a large, postmortem collection of human brains to assess the association between aneurysm formation and the presence of fenestrations. ⋯ Fenestrations of the intracranial arteries are a common anatomical finding. They are present most often in the anterior communicating artery. Most aneurysms were detected in the anterior communicating artery and middle cerebral artery. We conclude that the existence of an aneurysm in a fenestrated artery is an incidental, rather than causal, relationship.