World Neurosurg
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Vertebrobasilar artery nonsaccular aneurysms (VBANSAs) are associated with a 13% annual mortality. Revascularization and flow diversion are life-saving options in select cases; technical failures and rapid hemodynamic changes may contribute to unwanted outcomes. We describe a technique and report clinical outcomes of patients treated with an experimental slow-closing clip (SCC). ⋯ In this small case series, use of SCC overcame the natural history of VBANSAs when treatment timing and aneurysm anatomy were suitable. The SCC potentially favors aneurysm thrombosis and collateral reactivation. More studies are necessary to better develop the SCC.
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To assess the safety of foregoing invasive monitoring in a select group of patients undergoing awake craniotomy for supratentorial tumor resection. ⋯ Intraoperative physiologic control and surgical site complication avoidance do not warrant routine invasive blood pressure monitoring during awake craniotomy for tumor resection.
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Video 1 demonstrates the microsurgical resection of petrous apex meningioma. Even small lesions by general rules are regarded as large due to the delicate nature of anatomic localization. The intricate relationship between the tumor and vascular supply of the brainstem and interposition of cranial nerves makes them challenging lesions to resect.1 A 67-year-old female patient presented with a 6-month history of trigeminal neuralgia in the V2 and V3 branches. ⋯ The patient consented to the procedure. The postoperative course was uneventful. The patient's trigeminal neuralgia completely regressed with no new neurologic deficit.
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In recent years, biportal endoscopic surgery has gained popularity, and the number of publications on it has also increased. We herein aimed to investigate the complications of biportal endoscopic surgery. In this study, the available literature was reviewed systematically and the published complications of discectomy in biportal endoscopic spinal surgery were summarized. ⋯ Unilateral biportal endoscopic discectomy has an acceptable complication rate. Knowing the possible complications and risks of this procedure could help surgeons in taking measures to avoid common complications.
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Contrary to popular belief, the cerebellum is involved not only in motor planning, balance, and coordination but also in cognitive processes. The present study aimed to investigate executive functions (EFs), intellectual capacity, and psychiatric disorders in adults with type 1 Chiari malformation, which is defined as a hindbrain anomaly that involves the cerebellum. ⋯ The study found that subjects with type 1 Chiari malformation performed worse in EFs than healthy controls and had a higher prevalence of psychiatric disorders.