World Neurosurg
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Although pituitary adenomas and intracranial aneurysms often coexist,1 the locations of these lesions rarely affect surgical planning. In such cases, however, a simultaneous (rather than staged) approach avoids multiple procedures or delays in treating the dominant pathology. Building on limited prior reports of transnasal aneurysm clipping,2-6 we describe simultaneous transnasal treatment of an adrenocorticotropic hormone-secreting adenoma and a paraclinoid aneurysm in a 35-year-old woman (Video 1). ⋯ Postoperatively, the patient developed transient diabetes insipidus and hydrocortisone dependence but was neurologically intact and eupituitary on follow-up. With sufficient transnasal and vascular surgical experience, transnasal clipping of aneurysms can be safely performed in very selected cases. The patient consented to the procedures and publication.
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The effectiveness of gamma knife radiosurgery (GKRS) for the management of trigeminal schwannomas (TS) has been established. Although GKRS has been shown to inhibit tumor growth, the effect of GKRS on the symptoms caused by TS has not been sufficiently studied. In this study, symptomatic changes following GKRS for the management of symptomatic TS were investigated using long-term follow-up results. ⋯ GKRS can be an effective treatment modality for TS tumor control and shows favorable results in improving TS-related symptom, especially facial pain.
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During the pterional-transsylvian approach, we sometimes encounter the proximal Sylvian fissure (SF) deviating laterally beyond the fold of the sphenoidal ridge (SR) and experience difficulty dissecting the SF due to the deep and oblique dissection plane. In the present study, we explored the association between the height of the SR and lateral deviation of the SF during the pterional-transsylvian approach. ⋯ Small SR was associated with lateral deviation of the proximal SF.
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To evaluate the relationship between the oculomotor nerve (CNIII) and the internal carotid artery (ICA) as a new anatomic-radiologic landmark for distinguishing the exact location of a paraclinoid intracranial aneurysm (IA). ⋯ The intersection between the ICA and the CNIII, which crosses it transversely in its entire diameter, is a reliable anatomic-radiologic landmark to correctly classify paraclinoid aneurysms. Through a new MRI protocol, it is possible to radiologically identify this intersection and to easily distinguish the intracavernous and extracavernous ICA paraclinoid aneurysms.
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Here, we evaluate the evolution and growth of global neurosurgery publications over time, further focusing on the contributions and impact of authors in low- and middle-income countries (LMICs). ⋯ Despite recent growth, the number of global neurosurgery publications arising from LMICs pales in comparison to those from HICs. Collaborative efforts between certain HICs and LMICs have likely contributed to the observed increase in LMIC author independence over time.