World Neurosurg
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Laser interstitial thermal therapy (LITT) is a minimally invasive modality for addressing intracranial pathology. LITT is recognized as a primary therapeutic option for a range of intracranial pathologies, particularly in inaccessible lesions. In the present study, we systematically review the evidentiary base supporting contemporary applications of LITT. ⋯ In MTLE, LITT offers comparable rates of seizure freedom and reduction compared to anterior temporal lobectomy with potentially improved neuropsychiatric outcomes. LITT is an advantageous option for treating brain tumors, RN, and MTLE, among other pathologies. Continued investigation in emerging LITT applications can help clinicians expand the use of magnetic resonance imaging-guided stereotactic laser ablation technology into the treatment of a broad spectrum of central nervous system pathologies.
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Glioblastoma multiforme (GBM) is the most aggressive and prevalent type of malignant brain tumor, yet it metastasizes outside the central nervous system (CNS) in only 0.4% of cases. Little is known about what enables this subset of GBMs to take root outside the CNS, but genetic mutations likely play a role. ⋯ There is strong evidence that GBMs acquire novel mutations to survive outside the CNS. In some cases, tumor cells likely mutate after seeding scalp tissue during surgery, and in others, they mutate and spread without surgery. Future studies and genetic profiling of primary and metastatic lesions may help uncover the mechanisms of spread.
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To investigate the effect and safety of transradial stent angioplasty using double guide wires for severe stenosis of vertebral artery ostium at a lower location. ⋯ Transradial stent angioplasty using double guide wires is safe and effective for the treatment of severe stenosis of the vertebral artery ostium at a lower location even though more studies are necessary to confirm this.
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Endoscopic carpal tunnel release (ECTR) has advantages over open carpal tunnel release (OCTR); however, complications with ECTR are more likely to occur if the surgeon continues the procedure despite encountering difficulties. Techniques to minimize the need for conversion to OCTR have been infrequently discussed in the literature. This study aims to present a technique for performing ECTR without conversion to the open approach and to analyze the reasons for such conversions. ⋯ A thorough subligamentous extrabursal approach is essential for achieving a clear endoscopic view of the transverse carpal ligament and performing ECTR without the need for conversion to open surgery.