World Neurosurg
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Spontaneous spinal cerebrospinal fluid (CSF) leaks are uncommon but can be neurologically debilitating. When initial treatments fail, definitive repair or closure of the leak is indicated. ⋯ Among them are open surgical techniques using a transdural approach for the closure of ventral CSF leaks, minimally invasive tubular techniques for the reduction and repair of lateral meningeal diverticula, and endovascular embolization of CSF-venous fistulas. Illustrative cases demonstrating the indications for and implementation of these techniques are provided.
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Case Reports
A modified Anterior Petrosectomy Approach for Resection of Petroclival Meningioma; with management of complications.
Due to deep location and for being adjacent to neurovascular structures, petroclival meningiomas (PCMs) are generally considered to be associated with a high rate of recurrence and cranial nerve deficits.1 This video presents a 49-year-old female patient reporting right trigeminal neuralgia for more than 1 year. The incidence of this symptom with PCMs is about 5%.2 According to the classification system proposed by Kawase et al.3 and Ichimura et al.,4 this is a tentorium type PCM. ⋯ The treatments to the intraoperative trochlear nerve injury and temporal bridging vein occlusion are displayed (Video 1). The patient gave verbal consent for participating in the procedure and surgical video.
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Observational Study
Assessment of surgical treatment and outcome of chronic subdural hematoma at University of Gondar Comprehensive Specialized Hospital, a one year prospective study.
Chronic subdural hematomas (CSDHs) are a relatively common condition defined as an abnormal collection of blood and its break down products in the subdural space, usually accompanied by a history of preceding mild head trauma. Surgical management remains the mainstay of treatment. The objective of this study was to assess the surgical treatment outcome of patients operated on for CSDH at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. This comprehensive novel study serves as a benchmark for assessing therapeutic outcomes among patients with CSDH in the context of Ethiopia. ⋯ CSDHs are a relatively common condition characterized by an abnormal collection of blood. Antecedent trauma is the usual risk factor. Complication can happen following surgical intervention; however, patients with CSDH generally have a good prognosis.
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Surgery is effective in the treatment of epilepsy, particularly focal epilepsy. The aim of this work was to report the incidence and grade of severity of hemorrhagic complications after cranial epilepsy surgery, and investigate the risk factors. ⋯ Hemorrhagic complications were uncommon after open surgery for epilepsy. Most hemorrhagic complications were mild while the severe were rare. Patients with hemorrhagic complications had a good prognosis after effective treatment.
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The treatment of symptomatic Tarlov cysts remains a controversial topic within neurosurgery. We describe our experience with patients who underwent surgical intervention for sacral Tarlov cysts at a single institution. General and disease-specific outcome measures were used to assess health-related quality of life. ⋯ Our longitudinal series demonstrated patient-reported improvement following surgery for symptomatic sacral Tarlov cysts using a validated disease-specific health-related quality of life scale through 12 months after surgery. Patient age and preoperative duration of symptoms were not correlated with outcome.