World Neurosurg
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Occipital lobectomy is a widely accepted procedure for treatment of occipital gliomas and occipital lobe epilepsy,1,2 but its technical nuances are not well discussed. Anatomically, the occipital lobe, also known as the cuneus or visual area, is an isolated region in terms of vascular supply. The terminal branches of posterior cerebral arteries, including parieto-occipital and calcarine arteries,3-6 are the major vessels supplying this region. ⋯ The surgical procedure involved the dissection of the entire POF along with the parieto-occipital artery and early coagulation of the calcarine artery (Video 1). Postoperative magnetic resonance imaging confirmed the occipital lobectomy with the POF as the anterior border of the resection cavity. The patient exhibited no new neurological deficits postoperatively.
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Anterior column realignment (ACR) is a powerful minimally invasive surgery technique to restore sagittal alignment in adult spinal deformity (ASD). This can accomplish similar segmental lordosis restoration as 3-column osteotomy with less blood loss and comparable complication rates. ACR can be performed at adjacent disease segments in the proximal lumbar spine in revision cases. However, two thirds of physiologic lordosis occurs between L4-S1, and concerns remain about altered lumbar morphology. We evaluated patients who underwent proximal lumbar ACR for iatrogenic flatback deformity. ⋯ Proximal lumbar ACR plus Smith-Peterson osteotomy can achieve sagittal correction with low major complication rates in patients with ASD and prior distal fusion. Differentially increasing proximal lumbar lordosis and lowering lumbar distribution index did not have deleterious effects on radiographic or clinical outcomes. Further work is needed to understand the effect of proximal ACR in the surgical management of ASD.
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Spontaneous intracerebral hemorrhage (sICH) is a severe cerebrovascular disease with high mortality and disability. And its treatment strategies have always been a hotspot in clinical research. Endoscopic surgery (ES) is widely used for treating sICH. A comprehensive review of ES for sICH is warranted to provide better understanding and guidance for clinicians. We provide an updated overview of the surgical equipment, surgical indications and timing, and technical advancements, as well as therapeutic effects and future directions. ⋯ ES represents a significant advancement in the treatment of sICH. Its minimally invasive features, coupled with continuous methodological refinement, contribute to a lower mortality rate and better functional recovery compared to traditional methods. ES should be considered a significant option in the surgical management of sICH, necessitating further research and standardization to enhance patient care and outcomes.
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Traumatic brain injury (TBI) is a severe neurosurgical emergency and a significant public health concern. Fishing-speargun TBIs are included in nonmissile injuries and have been implicated in only few cases of TBI in the past 68 years, mainly of accidental etiology. ⋯ In summary, the diverse presentation, management, outcomes, and identified influencing factors highlight the complexity of managing speargun-related injuries, and the need for personalized approaches and further research to enhance care protocols.