World Neurosurg
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Microsurgical treatment of large and giant paraclinoid internal carotid artery (ICA) aneurysms often requires the use of the retrograde suction decompression (RSD) technique to facilitate clipping. Surgical results, functional outcomes at discharge, and technique limitations based on single institution series are presented. ⋯ Surgical clipping with the RSD method remains a treatment of choice with acceptable outcomes for patients not amenable for endovascular treatment.
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Case Reports
Combined intra- and extra-endoscopic techniques for aggressive resection of subependymal giant cell astrocytomas.
Although neuroendoscope is widely used, endoscopic removal of intraventricular solid tumors has rarely been reported. Most reported procedures were performed with special endoscopic instruments through the endoscope's working channel--intra-axial endoscopic procedures. We report two cases of combined intra-/extra-axial endoscopic procedures--intraventricular solid tumor resection for subependymal giant cell astrocytoma. ⋯ In the present report endoscopic minimally invasive neurosurgery (EMIN) was defined as procedures in which the endoscope was used independently as the only optical device, for both illumination and visualization. Depending on the relationship between surgical instruments and the endoscope, EMIN was classified as intra-axial and extra-axial procedures. EMIN is a completive, safe procedure for intraventricular subependymal giant cell astrocytoma.
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Randomized Controlled Trial
Efficacy of low-dose tissue-plasminogen activator intracisternal administration for the prevention of cerebral vasospasm after subarachnoid hemorrhage.
Vasospasm is one of the important factors associated with the functional prognosis after subarachnoid hemorrhage (SAH). Intracisternal administration of thrombolytic agents to dissolve subarachnoid clots may be responsible for bleeding complications. The efficacy and safety of cisternal irrigation therapy using low-dose tissue plasminogen activator were evaluated. ⋯ Cisternal irrigation therapy using low-dose tissue plasminogen activator is effective and safe. Intermittent injection is most effective and may decrease the risk of symptomatic vasospasm in patients with SAH.