World Neurosurg
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Neurosurgical care is difficult to access in many scenarios. Aeromedical evacuation of acutely unwell neurosurgical patients from remote, isolated, or poorly equipped locations can be considered. This article aims to provide a framework of logistical factors that deserve special consideration in the preparation of these patients for transfer. ⋯ Although there is little published information, this review provides useful criteria and parameters needed for safe aeromedical evacuation of neurosurgical patients.
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Surgical resection in gliomas invading the thalamus poses significant challenges due to the deep location and its localization near the ventricle. Ventricular entry (VE) during such operation is somewhat inevitable. However, the impact of VE on clinical outcomes is unclear. Additionally, it is unknown whether VE is associated with increased medical costs. ⋯ Although surgical VE does not impact survival, it may impose undesirable events and higher financial burdens for patients with gliomas invading the thalamus.
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Blister-like aneurysms represent a rare subtype characterized by a wide neck and dissecting appearance, predisposing them to perioperative rebleeding due to fragile walls. These aneurysms predominantly occur at non-branching sites of the internal carotid artery (ICA). Still, they may also manifest at atypical locations, including the anterior communicating artery (AComA), anterior cerebral artery, middle cerebral artery, posterior cerebral artery, and basilar artery.1 Treatment of blister-like aneurysms typically involves a combination of microsurgery and endovascular procedures, with no universally established optimal therapeutic approach. ⋯ During aneurysm surgery, an intraoperative rupture occurred that was controlled with a temporary clip. Sharp aneurysm dissection and then aneurysm clipping is made under the temporary clip. Six days after the operation, the patient was discharged home without any neurologic deficit.
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The neuroinflammatory response to aneurysmal subarachnoid hemorrhage (SAH) might have a crucial impact on the burden of disease. We aimed to analyze the behavior of interleukin-6 (IL-6) in cerebrospinal fluid (CSF) during SAH and its relation to complications and outcomes. ⋯ Our data confirm the substantial impact of neuroinflammation on SAH. CSF IL-6 values measured during the first week after SAH occurrence present the most valuable outcome predictors.