World Neurosurg
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Case Reports
Preventive Effect of Bypass Surgery on Rebleeding in Patients with Hemorrhagic Twig-like Middle Cerebral Artery.
Aplastic or twiglike middle cerebral artery (Ap/T-MCA) is a rare cerebrovascular anomaly correlated to stroke. The most common characteristic of the disease is intracerebral hemorrhage. However, treatment measures that can prevent rebleeding have not yet been established. ⋯ EC-IC bypass may be a treatment option that can prevent rebleeding in patients with hemorrhagic Ap/T-MCA.
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In our technical note, we have presented a technique of cranioplasty for large skull defects. ⋯ The presented technique is simple, safe, and time- and cost-effective. The technique and results are reproducible.
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We analyzed cortical landmarks, trajectory of approach, and various fiber tracts in the vicinity of our earlier described approach through the orbital/basal surface of the frontal lobe to access tumors located in the region of the caudate nucleus. We also present a new lateral orbital trajectory to approach these tumors. ⋯ Surgical approach to the caudate head through the orbital surface of the frontal lobe as described by us provides the shortest trajectory and safe surgical route to access tumors of the caudate nucleus.
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Meningiomas of the cavernous sinus (CS) present a neurosurgical challenge. The anatomic complexity of the area can create a potential for injury to neurovascular structures. This has traditionally limited total tumor removal. ⋯ CS surgery for meningioma is feasible with low morbidity and can provide benefits in improving preexisting cranial nerve dysfunction (Video 1).1-4 Complete resection of the CS meningiomas is possible in most cases. CS tumors remain a surgical challenge, but accurate knowledge of surgical neuroanatomy and surgical approaches facilitates their safe and effective treatment. The patient gave informed consent for surgery, use of images, and video publication.
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Chronic subdural hematomas (cSDHs) are an increasingly prevalent neurologic disease that often requires surgical intervention to alleviate compression of the brain. Management of cSDHs relies heavily on computed tomography (CT) imaging, and serial imaging is frequently obtained to help direct management. The volume of hematoma provides critical information in guiding therapy and evaluating new methods of management. We set out to develop an automated program to compute the volume of hematoma on CT scans for both pre- and postoperative images. ⋯ We successfully trained a convolutional neural network on a dataset of pre- and postoperative head CTs containing cSDH. This tool could assist with automated, accurate measurements for evaluating treatment efficacy.