World Neurosurg
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Trigeminal neuralgia (TN) has been described as one of the worst pains known to humankind. However, pain severity in TN has been measured using several different scales, resulting in difficulty comparing illness burden and response to TN surgery across studies. We examined the degree of concordance between standardized scales evaluating pain severity in a cohort of patients undergoing surgery for TN. ⋯ The degree of agreement across all three scores was moderate (ICC = 0.72). TN patients with residual mild-moderate pain after surgery are often discordantly classified by different pain measurement scales. These findings argue for a more standardized method of reporting port-operative pain outcomes in the TN literature.
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To present a global overview of the current research landscape and emerging trends in mechanical thrombectomy (MT) for acute ischemic stroke (AIS) over the past decade. ⋯ Interest in MT for AIS was progressively increasing. Future research directions may include minimizing intraoperative injuries, refining diagnostic techniques, investigating interventions for posterior circulation, and tailoring thrombectomy strategies based on stroke severity and LVO etiology.
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Video-assisted debriefing (VAD) is promising for medical skill training, but its effectiveness requires further exploration. The aim of this study was to investigate the effectiveness of point-of-view VAD in spinal surgery training. ⋯ VAD is more effective than traditional verbal debriefing for improving residents' surgical skills, particularly for obtaining a more comprehensive understanding of anatomical structures, imitating detailed surgical techniques as well as promoting initiative. However, in terms of mastery of surgical skills, VAD is not significantly beneficial for tactile perception of the surrounding tissue, indicating that a certain amount of practice is still necessary.
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Cavernous Carotid Aneurysms are typically small, asymptomatic, and often do not require treatment. We present the case of a 59-year-old woman, a three-pack-a-day smoker, who presented with the primary complaint of left retro-orbital pain, left complete ophthalmoplegia, left-sided blindness, and right abducens palsy. Imaging revealed a giant right cavernous carotid aneurysm, which had expanded to the contralateral cavernous sinus wall as well as superiorly through the diaphragm sellae. ⋯ Post-operative CTA confirmed placement of the clips and patency of the vessel. At short term follow up, the patient's trigeminal pain had successfully resolved and she had retained vision in the right eye. This case demonstrates the feasibility of expanded endonasal approaches in managing this challenging pathology.
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Ventriculoperitoneal (VP) shunt surgery is the primary treatment for patients with idiopathic normal pressure hydrocephalus (iNPH). This study compares the outcomes of VP shunt placement using electromagnetic (EM) navigation versus standard methods in iNPH patients, focusing on catheter accuracy and post-operative complication rates. ⋯ The use of EM navigation in VP shunts for iNPH patients improves catheter placement accuracy, reduces postoperative complications and shunt malfunction rates, and provides precise and individualized surgical treatment.