World Neurosurg
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Posterior cervical approaches for atlantoaxial and craniovertebral junction pathologies with or without instrumentation are often associated with excessive soft tissue dissection and bleeding consequent with disruption of the venous plexus. A few minimally invasive approaches to this region have been reported from clinical and cadaveric studies in an effort to minimize blood loss, reduce soft tissue dissection, and decrease postoperative pain; however, unilateral minimally invasive approaches have not been described. Here, we describe a minimally invasive atlantoaxial and craniovertebral approach. ⋯ We present a novel, unilateral minimally invasive approach to reach the atlantoaxial and craniovertebral junction. This could allow for faster postoperative recovery, less pain and opioid requirement, and increased maintenance of atlantoaxial stability. Such a technique, after being confirmed in patients, could optimize this surgical technique.
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To review the clinic value and severity assessment of serum substance P (SP) concentration in children with different degrees of traumatic brain injury (TBI) through analyzing correlations with outcomes. ⋯ Serum SP concentration was associated with severity in children with TBI, and extremely high levels indicated a poor prognosis.
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Sporadic vestibular schwannoma (VS) is a benign primary tumor that arises from the vestibular nerve. Growing VS can negatively compress the brain stem, which can lead to death. MicroRNAs (miRNAs) can negatively regulate target genes at the post-transcriptional level and are critical in tumorigenesis. Studies have demonstrated the tumor suppressive function of microRNA-205-5p (miR-205) across many cancers, but no studies have evaluated the role of miR-205 in sporadic VS. We conducted this study to examine the role of miR-205 in sporadic VS cell proliferation. ⋯ These findings suggested that miR-205 suppressed sporadic VS proliferation by targeting CDK14 and may be considered as a potential drug therapy for sporadic VS treatment in the future.
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Aneurysm clipping requires the proficiency of several skills, yet the traditional way of practicing them has been recently challenged, especially by the growth of endovascular techniques. The use of simulators could be an alternative educational tool, but some of them are cumbersome, expensive to implement, or lacking in realism. The aim of this study is to evaluate a reusable low-cost 3-dimensional printed training model we developed for aneurysm clipping. ⋯ The main strengths of our training model are its highlighted realism, adaptability to trainees of different levels of expertise, sustainability, and low cost. Our data support the concept that it can be incorporated as a new training opportunity during professional specialty meetings and/or within residency academic programs.
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Aneurysmal subarachnoid hemorrhage (aSAH) in the elderly often has a poor prognosis even after surgical treatment in the acute phase. Additionally, subarachnoid clots are the strongest predictors of cerebral vasospasm and tend to be thicker and heavier due to cerebral atrophy. We aimed to compare the conventional surgical treatment in such patients and identify the independent predictors of a favorable outcome after aggressive surgical clot removal. ⋯ In elderly patients with aSAH in the acute phase, aggressive surgical clot removal after clipping showed favorable outcomes by facilitating early out-of-bed mobilization.