World Neurosurg
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Using a cadaveric model, we compared endoscope-assisted retrosigmoid (EAR) and endoscope-assisted retrolabyrinthine posterior petrosal (EARPP) approaches towards the petroclival area, regarding surgical exposure and instrument maneuverability, also verifying how some petroclival morphometric parameters correlate with these variables. ⋯ Endoscopic techniques can spare the need for additional steps of greater morbidity when approaching the petroclival area in both routes. A simpler and faster approach as EAR was favored over EARPP in this standardized quantitative assessment. The petroclival angle and clival depth may interfere with maneuverability, but not with surgical exposure in both endoscope-assisted approaches.
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Our aim was to assess the 5-year h-index (h5)-index by nation. We aimed to assess the relationship between a nation's h5-index and numbers of neurosurgeons, population, gross domestic product (GDP), and expenditure on both health and research. ⋯ This is the first study to explore the h-index between nations on an international level. GDP and proportion of GDP spent on health expenditure are the strongest correlates of the h5-index. Although a higher number of neurosurgeons in a nation does result in more publications, this is not necessarily translated into higher quality research.
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Surgical intervention for chronic subdural hematoma (CSDH) in the extremely aged population remains a difficult challenge. This study aims to investigate the clinical characteristics and surgical outcomes after twist drill craniotomy (TDC) of CSDH in super-elderly (≥80 years) patients. ⋯ Advanced age per se does not seem to be a contraindication for the operative intervention of CSDH. Surgical treatment using the TDC procedure can still provide considerable benefits for super-elderly patients with CSDH.
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Traumatic carotid cavernous fistulas (TCCFs) and traumatic intracranial pseudoaneurysms are uncommon vascular anomalies associated with head trauma.1,2 Detachable balloons, covered stents, or liquid embolic agents can be used to treat TCCFs in some conditions.3,4 TCCF concomitant with pseudoaneurysm is an extremely rare occurrence in the literature.5,6 In Video 1, we present a unique case of a TCCF concomitant with a giant pseudoaneurysm of the posterior communicating segment of the left internal carotid artery in a young patient. Both lesions were successfully managed with an endovascular treatment using a Tubridge flow diverter (MicroPort Medical Company, Shanghai, China), coils, and Onyx 18 (Medtronic, Bridgeton, Missouri, USA). ⋯ This video shows a new treatment method for TCCF concomitant with a pseudoaneurysm. The patient consented to the procedure.