World Neurosurg
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Low-grade glioma (LGG) usually occurs in young patients who enjoy an active family, social, and professional life. Because awake surgery for patients with LGG has resulted in significant improvement in both functional and oncological outcomes and because the surgery per se is not very expensive, it is currently performed in many countries worldwide. Nonetheless, in addition to the necessity of tailoring the surgical strategy to the patient (e.g., neurological and cognitive status) and tumor (e.g., brain location and volume) characteristics, the legal, cultural, and socioeconomic parameters could also play a key role in the therapeutic strategy. ⋯ These criteria are relevant with respect to the diagnosis, surgery, functional remediation, and long-term follow-up for patients who now benefit from a longer life expectancy. However, although such factors are essential to resume an active life, including returning to work, they vary greatly across countries. Therefore, they should be considered more systematically to allow for greater reproducibility of results of awake surgery worldwide.
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Review
Skull base venous anatomy associated with endoscopic skull base neurosurgery: a literature review.
An understanding of the anatomy and function of the skull base venous channels is fundamentally important for safe performance of endoscopic surgery for skull base lesions. This review focuses on 4 skull base venous channels-namely, the intercavernous sinuses, basilar plexus, osseous veins, and inferior petroclival vein-because these have been less recognized by neurosurgeons than other major venous channels such as the inferior petrosal sinus. We reviewed the literature concerning these 4 venous channels and discussed their anatomy and function. ⋯ Because of their location, they occasionally obstruct the surgical view and are sometimes implicated in intraoperative hemorrhage, air embolism during endoscopic skull base surgery, and postoperative hematoma. They usually function as a venous reservoir of cranial venous drainage; however, they are less often directly involved in normal brain perfusion. Knowledge about the functional and morphologic anatomy of the skull base venous channels is important for neurosurgeons to avoid unexpected complications during endoscopic skull base surgery.
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Determining the value of the computed tomographic black hole sign in predicting postoperative rehemorrhage in patients with intracranial hemorrhage (ICH) underwent minimally invasive surgery (MIS). ⋯ The black hole sign on initial CT could predict the postoperative rehemorrhage following the minimally invasive procedures.
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Cerebral abscesses after brain surgery are rare but severe and life-threatening complications. We sought to analyze the clinical aspects of those patients and thereby reveal risk factors and the relevant aspects for their future therapy. ⋯ Secondary brain abscess is a rare complication and occurs mainly in patients with tumors and patients receiving emergency surgery. In total, 41% of the patients suffered from a S. aureus infection. Isolation of the responsible microorganisms is often possible and leads to improved outcomes.
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To characterize the learning curve for a single surgeon during his initial phases of performing minimally invasive surgery oblique lumbar interbody fusion. ⋯ Minimally invasive surgery oblique lumbar interbody fusion presents a learning curve to the practicing spine surgeon with regard to operative time, x-ray exposure time, and intraoperative and postoperative complications. Close attention to detail can minimize complications that may be associated with the learning curve.