World Neurosurg
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To analyze the clinical characteristics, immunohistochemistry, and treatment outcomes for skull base chordomas and the correlation between extent of resection/pathology type and outcomes. ⋯ Aggressive surgical resection should be performed for skull base chordomas, considering certain postoperative functional status. Immunohistochemical study is helpful in differential diagnosis. The combination of aggressive surgical resection and gamma knife radiosurgery for skull base chordomas may obtain favorable outcomes.
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Historical Article
Supplementing the neurosurgical virtuoso: evolution of automation from mythology to operating room adjunct.
A central concept of scientific advancement in the medical and surgical fields is the incorporation of successful emerging ideas and technologies throughout the scope of human endeavors. The field of automation and robotics is a pivotal representation of this concept. ⋯ We trace the growth of this field from the seminal concepts of Homer and Aristotle to early incorporation into neurosurgical practice. Resulting changes provide drastic and welcome advances in areas of visualization, haptics, acoustics, dexterity, tremor reduction, motion scaling, and surgical precision.
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Coiling of aneurysms 3 mm in diameter or less has been associated with a relatively high rate of complications, including iatrogenic rupture. The present study aimed to determine the clinical outcome of our technique for coiling small aneurysms. ⋯ Aneurysms 3 mm in diameter or smaller can be coiled safely with the use of both bare platinum and hydrogel-coated coils. In most cases, coiling of small aneurysms can be performed without the use of adjunctive devices such as balloons or stents.
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Case Reports
Successful Onyx embolization of a giant glomus jugulare: case report and review of nonsurgical treatment options.
Otorrhagia is an uncommon but severe symptom of patients with large glomus jugulare tumors that erode through the tympanic membrane. In this case report we describe the use of transarterial embolization for long-term palliative management of otorrhagia in a patient with an unresectable glomus jugulare tumor. ⋯ Long-term control of otorrhagia from glomus jugulare tumors can be safely achieved by intravascular embolization with Onyx.
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This study was designed to evaluate the clinical, radiologic, histologic, and surgical outcome characteristics of this disease treated in a single institution. ⋯ Primary adult infradiaphragmatic craniopharyngiomas are relatively rare lesions occurring in young adults. Pituitary dysfunction, visual acuity and/or field deterioration, and headache were the most common chief symptoms. Transsphenoidal surgery, including tearing the cyst walls off the diaphragma sellae and protecting normal pituitary tissue as much as possible, is recommended. Although at the risk of impairing the function of anterior pituitary, transsphenoidal surgery results in a high rate of both visual field and hyperprolactinemia improvement with a low associated risk of recurrence. In terms of pathological aspects, the adamantinous subtype was more common.