World Neurosurg
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Case Reports
Posterior Transtemporal Approach to a Thalamic Cavernous Malformation: 2-Dimensional Operative Video.
Cavernous malformations (CMs) account for 10%-15% of all vascular malformations and represent the second most common type of cerebral vascular lesion.1 They typically occur in the cerebral subcortex or white matter.2 CMs located in the thalamus are rare.3 When we isolate the group of thalamic CMs, we find a bleeding risk of >5% per year, with a rebleeding rate exceeding 60%, often occurring within 1 year of the initial bleeding.1 The deep location and proximity to eloquent brain regions make thalamic CMs challenging for neurosurgeons.4,5 Surgeons can access the posterolateral thalamus through various surgical approaches, such as transcallosal transventricular, supracerebellar transtentorial, intraparietal sulcus, and transcortical methods. Selecting the best surgical approach requires considerable expertise, considering the patient's preoperative condition and the lesion's location.6-12 We discuss a complex case involving a 24-year-old patient with a right thalamic cavernoma and a history of 3 prior bleeding events. ⋯ The patient consented to the procedure and publication of images. We demonstrate how the transtemporal posterior trajectory provides an optimal working corridor for safely removing this cavernous malformation without introducing new deficits.
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We report our early clinical experience with image-guided, pencil beam scanning proton beam therapy (PBS-PBT) for residual and recurrent craniopharyngioma. ⋯ Our preliminary experience with modern PBS-PBT and image guidance for craniopharyngioma is encouraging. Proton therapy in our cohort was well tolerated, resulting in limited toxicity and promising early outcomes.
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To investigate the influence of sacroiliac interosseous ligament tension and laxity on the biomechanics of the lumbar spine. ⋯ While sacroiliac interosseous ligament laxity and tension have little effect on disc deformation and stress, and nucleus pulposus pressure, they reduce the stability of the lumbar-sacral vertebrae. In a forward flexion state, the lumbar ligaments bear a large load and are prone to laxity, thereby increasing the risk of lumbar injury.
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Several studies are currently exploring the anatomical origins of superior longitudinal fascicule (SLF) 2 and SLF-3, which are components of the frontoparietal network. This study aimed to achieve optimum visualization of the anatomical corridors of these fibers using Photoshop filters. ⋯ The visual descriptions of the dissections were enriched after using Photoshop to avoid monotony. Increasing the visual quality with Photoshop features enable us to gain a better understanding of these pathways. Additionally, it facilitates the comprehension of the symptoms associated with pathology. We hope these results will further aid in reducing the occurrence of postoperative complications.