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Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Surgical Resection for the Treatment of Patients With Vestibular Schwannomas: Update.
[BACKGROUND] Surgical intervention remains an important option in the management of vestibular schwannoma (VSs). Development of a systematic approach to choose the most appropriate route for this intervention, based on existing published ev…
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High-Resolution Vessel Wall Imaging for Treatment Sequencing of Multiple Aneurysms in Subarachnoid Hemorrhage.
[OBJECTIVES] Approximately 30% of patients with subarachnoid hemorrhage (SAH) present with multiple aneurysms. Identifying the ruptured aneurysm is often difficult, and not all lesions may be accessible through a single craniotomy. Magnetic…
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A Guide to Intracranial Bypass Suture.
[INTRODUCTION] Cerebrovascular bypass surgery is technically demanding, with dozens of modifiable parameters influencing operative decision-making. Thoughtful selection of needle and suture materials is critical to success in these operatio…
- Optimal timing of microsurgical resection after preoperative embolization of intracranial arteriovenous malformations: A systematic review and meta-analysis of 1,469 patients.
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Aneurysm formation and postcoiling recurrence in HIV-associated vasculopathy: illustrative case.
[BACKGROUND] Human immunodeficiency virus (HIV) infection is linked with an uncommon vasculopathy syndrome, increasing the susceptibility of infected individuals to develop aneurysms across systemic vasculature, notably in the cerebral vasc…
- Extended Retrosigmoid Craniotomy for Resection of an Abducens Schwannoma.
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Profound Pneumocephalus and Low-Pressure Hydrocephalus Triggered by Ventriculoperitoneal Shunt Placement after Resection, Fat Graft Reconstruction, and Radiotherapy for a Malignant Skull Base Schwannoma.
Tension pneumocephalus is a rare postoperative complication, typically presenting with mental status changes or rapid neurological decline after craniotomy. We report a complex case of tension pneumocephalus triggered by graft retraction a…
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Arteriovenous malformations in the cerebellopontine angle: assessment of the "backdoor resection" technique and microsurgical results in 38 patients.
[OBJECTIVE] Posterior fossa arteriovenous malformations (AVMs) represent 7% to 15% of all intracranial AVMs and are associated with an increased risk of hemorrhage, morbidity, and mortality compared with supratentorial AVMs, thus prompting …
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Salvage radiosurgery following subtotal resection of vestibular schwannomas: does timing influence tumor control?
[OBJECTIVE] The goal of microsurgical resection of vestibular schwannoma (VS) is gross-total resection (GTR) to provide oncological cure. However, a popular strategy is to halt the resection if the surgical team feels the risk of cranial ne…
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Thrombotic, Dolichoectatic, Distal Posterior Cerebral Artery Aneurysm Treated with Excision and P2-P2 Reanastomosis.
Posterior cerebral artery aneurysms are rare and often optimally treated with clip reconstruction. Complex cases may require aneurysm excision with in situ reanastomosis. A woman in her early 40s presented with 2 weeks of severe headache an…
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Double-Interposition Bypass: Technical Case Report of a Novel Intraoperative Bypass Salvage Technique.
[BACKGROUND AND IMPORTANCE] Complex cerebrovascular bypass operations may confer an increased risk of intraoperative complications, such as graft thrombosis. Novel techniques are needed to optimize the management of these challenging cases.…
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The LazyBox Educational Intervention Trial: Can Longitudinal Practice on a Low-Fidelity Microsurgery Simulator Improve Microsurgical Skills?
Introduction Every surgical trainee must acquire microsurgical skills within a limited timeframe. Therefore, identifying effective educational strategies to help learners attain these skills is crucial. Objective Establish the effectiveness…
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Management of basilar fenestration aneurysms: a systematic review with an illustrative case report.
[BACKGROUND] Basilar artery (BA) fenestration aneurysm (BAFA) is a rare phenomenon commonly accompanying other aneurysms. Treatment is challenging, and few cases have been reported. This review investigated the management outcomes of BAFAs.…
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Clinical Trials of Microsurgery for Cerebral Aneurysms: Past and Future.
[BACKGROUND] New findings and research regarding the microsurgical treatment of intracerebral aneurysms (IAs) continue to advance even in the era of endovascular therapies. Research in the past 2 decades has continued to revolve around the …
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The Early Bird Gets the Worm: Introducing Medical Students to Microsurgical Technique via a Low-Cost, User-Friendly, Reusable Simulation System.
[BACKGROUND] Mastery of microsurgical technique requires thousands of hours of deliberate practice, often with equipment that is not accessible to medical students. This study aimed to develop, test, and report a novel simulation system for…
- Countertop Microsurgery for Medical Students: Letter to the Editor Regarding "Lazy Glass Microsurgical Trainer: A Frugal Solution for Microsurgical Training".
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Long-term outcomes of grade I/II skull base chondrosarcoma: an insight into the role of surgery and upfront radiotherapy.
[PURPOSE] To clarify the need for post-operative radiation treatment in skull base chondrosarcomas (SBCs). [METHODS] A retrospective analysis of patients with grade I or II SBC. Patients were divided according to post-surgical treatment st…
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Surgery versus radiosurgery for facial nerve schwannoma: a systematic review and meta-analysis of facial nerve function, postoperative complications, and progression.
[OBJECTIVE] Intracranial facial nerve schwannomas (FNS) requiring treatment are frequently recommended for surgery or stereotactic radiosurgery (SRS). The objective of this study was to compare facial nerve function outcomes between these t…
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Carotid Artery Injury during Transsphenoidal Pituitary Surgery: Lessons from a 15-Year Modern Microsurgery Cohort.
Internal carotid artery (ICA) injury is a rare but potentially catastrophic complication of transsphenoidal resection (TSR) of pituitary tumors, potentially resulting in a host of deficits due to the risk of hemorrhage, ischemia, or even d…