Endoscopic management of an intrasellar arachnoid cyst through the tuber cinereum in an adult: a case report
This report highlighted an alternative approach through the tuber cinereum (denoted as “trans-tuberal”), which enabled the treatment of symptomatic cases with a small opening for cyst fenestration in the infundibular recess. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Scalp thickness as a predictor of wound complications after cerebral revascularization using the superficial temporal artery: a risk factor analysis
AbstractObjectiveCerebral revascularization using the superficial temporal artery diverts some of the blood supply from the scalp to the brain. This may compromise the blood supply to the scalp and could result in more wound complications.ObjectiveThis retrospective chart review aimed to identify the incidence of, and independent risk factors for, wound complications after cerebral revascularization using the superficial temporal artery.MethodsPatients who underwent cerebral revascularization using the superficial temporal artery between January 2003 and February 2017 were studied. Minor wound complications included superf...
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Trapped fourth ventricle —treatment options and the role of open posterior fenestration in the surgical management
ConclusionMultiple surgical approaches have been described for TFV. Endoscopic fourth ventriculostomy with aqueductoplasty is gaining popularity in the past two decades. However, an open posterior fenestration of the midline fourth ventricle outlet (magendieplasty) along with sharp arachnoid dissection (adhesiolysis) along the cerebello-medullary cisterns and paracervical gutters is relatively simple and provides physiological fourth ventricular CSF outflow. This is especially useful in TFV with syrinx as the craniospinal CSF circulation is established. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Treatment of posttraumatic syringomyelia: evidence from a systematic review
ConclusionEven diagnosing PTS early in its evolution with MRI, to date, no satisfactory standard treatment exists, and the present literature review shows similar outcomes, regardless of the treatment modality. Therefore, PTS remains a neurosurgical challenge. Additional research is required using appropriate study designs for improving treatment options. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Detecting small conflicting drainages with contrast-enhanced magnetic resonance venography for surgical planning: a technical description and quantified analysis
ConclusionsThe resolution of the CE-MRV in the present study met the requirement for detection of small conflicting vessels during SEEG planning. The visualized venous landmarks could be used for visual guidance to the surgical zone. As a non-invasive approach, CE-MRV is practical to use in the clinical setting. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

In vitro performance of six combinations of adjustable differential pressure valves and fixed anti-siphon devices with and without vertical motion
AbstractObjectiveAdjustable differential pressure (DP) valves in combination with fixed anti-siphon devices are currently a popular combination in counteracting the effects of cerebrospinal fluid overdrainage following implantation of a ventriculoperitoneal shunt system. The study examined the flow performance of three DP valves in successive combination with an anti-siphon device in an in vitro shunt laboratory with and without vertical motion.MethodsWe analyzed three DP valves (Codman Hakim Medos programmable valve [HM], Codman CertasPlus [CP], and Miethke proGAV [PG], in combination with either Codman SiphonGuard [SG] o...
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Outcome of nonneoplastic pituitary cysts during conservative monitoring and after surgery —a SwissPit study
ConclusionsAsymptomatic nonneoplastic pituitary cysts may be monitored; many lesions may shrink with time. Larger or T1-hypo-/T2-hyper cysts have higher growth rates. If indicated, surgery for nonneoplastic sellar cysts is a safe and efficient. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Paradoxical response of intracranial pressure to shunt valve setting adjustments
This study describes the effect of adjusting the shunt valve setting on ICP in a cohort of patients with complex symptom management.MethodSingle-centre retrospective observational study. Patients who underwent ICP-guided valve setting adjustments during 24-h continuous ICP monitoring, between 2014 and 2019, were included. Patients with suspected shunt malfunction were excluded. Median night ICP before and after the valve adjustments were compared ( Δ night ICP). The responses of ICP to valve adjustment were divided into 3 different groups as follows: expected, paradoxical and no response. The frequency of the paradox...
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Amygdalar and hippocampal beta rhythm synchrony during human fear memory retrieval
ConclusionsThus, our observation that the amygdala-hippocampal system contributing to fear memory retrieval in human with frequency-depended specificity has provided new insights into the mechanism of fear and have potential clinical relevance. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Superior accuracy and precision of SEEG electrode insertion with frame-based vs. frameless stereotaxy methods
AbstractBackgroundStereotactic electroencephalography (SEEG) has largely become the preferred method for intracranial seizure localization in epileptic patients due to its low morbidity and minimally invasive approach. While robotic placement is gaining popularity, many centers continue to use manual frame-based and frameless methods for electrode insertion. However, it is unclear how these methods compare in regard to accuracy, precision, and safety. Here, we aim to compare frame-based insertion using a CRW frame (Integra ®) and frameless insertion using the StealthStation™ S7 (Medtronic®) navigation system ...
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

High-intensity vessel sign on fluid-attenuated inversion recovery imaging: a novel imaging marker of high-risk carotid stenosis —a MRI and SPECT study
AbstractBackgroundMeasurement of luminal stenosis and determination of plaque instability using MR plaque imaging are effective strategies for evaluating high-risk carotid stenosis. Nevertheless, new methods are required to identify patients with carotid stenosis at risk of future stroke. We aimed to clarify the mechanisms and clinical implications of the hyperintense vessel sign (HVS) as a marker of high-risk carotid stenosis.MethodsWe included 148 patients who underwent carotid stent (CAS) or carotid endarterectomy (CEA). MRI FLAIR was performed to detect HVS prior to and within 7 days after CAS/CEA. MR plaque imaging an...
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Selective perioperative steroid supplementation protocol in patients undergoing endoscopic transsphenoidal surgery for pituitary adenomas
ConclusionsOur steroid sparing protocol was both safe and effective. The 15% incidence of protocol deviations is a reminder that the rigorous usage of checklists is mandatory for successful clinical practice. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Central retinal artery occlusion occurring 30 years after successful revascularization surgery for moyamoya disease: case report
We report a case of central retinal artery occlusion (CRAO) leading to unilateral blindness occurring in a moyamoya patient 30  years after successful pial synangiosis when she was 6 years old. Imaging studies at the time of the CRAO revealed total occlusion of the ipsilateral cervical and intracranial internal carotid artery, a vessel shown to be patent on MRI/MRA studies for decades previously. This case demonstrates th at long-term follow-up of operated moyamoya patients may reveal late secondary complications, of which physicians, patients, and families need to be aware. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Stereotactic CT image guidance and biplanar fluoroscopy for transoral C2 vertebroplasty and direct anterolateral subaxial vertebroplasty: a surgical technique note on access to the axial and subaxial spine
ConclusionQuality of life preservation is paramount in the management of metastatic spine disease. Vertebroplasty of osteolytic lesions can both relieve pain and restore stability, thus avoiding permanent stiff cervical collar, halo vest, or upfront occipitocervical fusion. With the increasing availability of surgical navigation systems, its use combined with biplanar fluoroscopy for performing transoral C2 vertebroplasty seems to be an adequate treatment in selected cases for pain relief, stabilization, and maintaining quality of life in the complex cancer population with C2 pathological fractures. The article describes a...
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Sub-decapitation in suicidal chainsaw injury: report of a rare case and operative management
We report the case of a 23-year-old man who attempted suicide by sub-decapitation with a chainsaw, its successful (peri-) operative management, and clinical course along with a discussion of the contemporary management and body of evidence of such lesions. Chainsaw injuries are severe traumas. Stepwise surgery with maximal functional reconstruction is safe and optimal clinical outcome can be achieved. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Letter to the editor regarding “How I do it: operative nuances of multiple burr hole surgery for moyamoya disease and syndrome”
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

VNS implantation in a NF1 patient: massive nerve hypertrophy discovered intra-operatively preventing successful electrode placement. Case report
We report our intraoperative unexpected finding of a massively enlarged vagus nerve in a patient with neurofibromatosis type 1 (NF1). The nerve hypertrophy prevented wrapping the coils of the helical electrode. The patient had no signs of vagus nerve dysfunction preoperatively (no hoarseness or dysphonia). This exceptional mishap is undoubtedly related to NF1-associated peripheral nerve sheath tumors. Even though it is not advisable to routinely perform any imaging prior to VNS, in such specific context, preoperative imaging work-up, especially cervical ultrasound, might be judicious to rule out any asymptomatic enlarged l...
Source: Acta Neurochirurgica - September 11, 2020 Category: Neurosurgery Source Type: research

Long-term apparent diffusion coefficient value changes in patients undergoing radiosurgical treatment of meningiomas
AbstractPurposeA noninvasive method to predict the progress or treatment response of meningiomas is desirable to improve the tumor management. Studies showed that apparent diffusion coefficient (ADC) pretreatment values can predict treatment response in brain tumors. The aim of this study was to analyze changes of intratumoral ADC values in patients with meningiomas undergoing conservative or radiosurgery.MethodMR images of 51 patients with diagnose of meningiomas were retrospectively reviewed. Twenty-five patients undergoing conservative or radiosurgery treatment, respectively, were included in the study. The follow-up da...
Source: Acta Neurochirurgica - September 9, 2020 Category: Neurosurgery Source Type: research

Stereotactic accuracy of stereoelectroencephalography procedures should be measured at both the entry and target points
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 9, 2020 Category: Neurosurgery Source Type: research

Metastatic renal cell carcinoma to the brain: optimizing patient selection for gamma knife radiosurgery
AbstractIntroductionThe effects of single-fraction gamma knife radiosurgery (sf-GKRS) on patients with renal cell carcinoma (RCC) brain metastases (BM) in the era of targeted agents (TA) and immune checkpoint inhibitors (ICI) are insufficiently studied.Methods and materialsClear cell metastatic RCC patients treated with sf-GKRS due to BM in 2005 –2014 at three European centres were retrospectively analysed (n = 43). Median follow-up was 56 months. Ninety-five percent had prior nephrectomy, 53% synchronous metastasis and 86% extracranial disease at first sf-GKRS. Karnofsky performance status (KPS) ranged from 60 to 10...
Source: Acta Neurochirurgica - September 9, 2020 Category: Neurosurgery Source Type: research

Percutaneous image-guided biopsy in malignant peripheral nerve sheath tumors
ConclusionWe found nearly a third of patients undergoing biopsy had a biopsy-related complication. The single largest complication was the inability to obtain an accurate diagnosis (21.9%) with the first biopsy. This may lead to the need for repeat percutaneous or open biopsies, or a non-oncologic initial surgery with implications for disease-free and overall survival. Neurologic complications including exacerbation of pain or a deficit were rare and transient. It remains important that clinicians balance the potential risks and benefits based on individual patient characteristics when determining the necessity of an image...
Source: Acta Neurochirurgica - September 8, 2020 Category: Neurosurgery Source Type: research

Ultra-short antibiotic prophylaxis guided by preoperative microbiological nasal swabs in endoscopic endonasal skull base surgery
ConclusionsOur study confirmed the safety and efficacy of our easily applicable and low-cost antibiotic prophylaxis protocol. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 8, 2020 Category: Neurosurgery Source Type: research

Microvascular decompression for trigeminal neuralgia attributable to the vertebrobasilar artery: decompression technique and significance of separation from the nerve root
This study aimed to review the clinical features of VBA involvement in trigeminal neuralgia and evaluate surgical decompression techniques in the long term.MethodsWe retrospectively reviewed the surgical outcomes of 26 patients (4.4%) with VBA involvement in 585 consecutive MVDs for TGN using a Teflon roll for repositioning the VBA. The final operative status of the nerve decompression was categorized into two groups: the separation group and the contact group. Separation of the VBA from the nerve root was completed in 13 patients in the separation group, and slight vascular contact remained in the remaining 13 patients of...
Source: Acta Neurochirurgica - September 8, 2020 Category: Neurosurgery Source Type: research

Visual field restoration after Simpson grade I resection of symptomatic occipital lobe meningioma: illustrative case and review of the literature
AbstractIntracranial meningiomas mostly affect patients in their fifth decade and beyond, raising pertinent questions regarding the risk of surgery, particularly in the elderly. Here, we describe the case of a septuagenarian patient with occipital meningioma causing severe visual field cuts that experienced full recovery of the visual function after a Simpson I resection of the lesion. This case illustrates the potential of recovery of the brain, even in the case of severely impaired function in elderly patients. To complete the picture, we review the literature on occipital meningiomas, advocating for systematic reports a...
Source: Acta Neurochirurgica - September 8, 2020 Category: Neurosurgery Source Type: research

Chiari malformation type I and basilar invagination originating from atlantoaxial instability: a literature review and critical analysis
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 7, 2020 Category: Neurosurgery Source Type: research

The endoscope-assisted supraorbital “keyhole” approach for anterior skull base meningiomas: an updated meta-analysis
ConclusionsIn the context of diverse study populations, the eSKA appeared not to be associated with increased adverse outcomes when compared with mTCA and EEA and offered comparable effectiveness. Case-selection is paramount in establishing a role for the eSKA in anterior skull base tumours. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 5, 2020 Category: Neurosurgery Source Type: research

Eyebrow supraorbital keyhole craniotomy for olfactory groove meningiomas with endoscope assistance: case series and systematic review of extent of resection, quantification of postoperative frontal lobe injury, anosmia, and recurrence
ConclusionThe eyebrow incision supraorbital keyhole craniotomy with endoscopic assistance is a safe and effective approach to OGM with tumor control rates similar to more invasive open approaches and better than the endonasal approach. Rates of frontal lobe injury, CSF leak and anosmia are comparatively low. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 5, 2020 Category: Neurosurgery Source Type: research

Visual outcomes endorse surgery of patients with spheno-orbital meningioma with minimal visual impairment or hyperostosis
ConclusionWe recommend surgery, even of patients with minimal visual impairment or hyperostosis, as patients who present with deteriorated visual function or extensive hyperostosis are less likely to have postoperative visual outcomes restored to normal. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 4, 2020 Category: Neurosurgery Source Type: research

Letter to the editor regarding: “High prevalence of pro-thrombotic conditions in adult patients with moyamoya disease and moyamoya syndrome: a single center study”
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 4, 2020 Category: Neurosurgery Source Type: research

Response to letter to the editor: High prevalence of pro-thrombotic conditions in adult patients with moyamoya disease and moyamoya syndrome: a single center study
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 4, 2020 Category: Neurosurgery Source Type: research

Descriptive analysis of low versus elevated intracranial pressure on cerebral physiology in adult traumatic brain injury: a CENTER-TBI exploratory study
AbstractBackgroundTo date, the cerebral physiologic consequences of persistently elevated intracranial pressure (ICP) have been based on either low-resolution physiologic data or retrospective high-frequency data from single centers. The goal of this study was to provide a descriptive multi-center analysis of the cerebral physiologic consequences of ICP, comparing those with normal ICP to those with elevated ICP.MethodsThe Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) High-Resolution Intensive Care Unit (HR-ICU) sub-study cohort was utilized. The first 3  days of phys...
Source: Acta Neurochirurgica - September 4, 2020 Category: Neurosurgery Source Type: research

Surgical anatomy and nuances of the expanded transpterygoid approach to the pterygopalatine fossa and upper parapharyngeal space: a stepwise cadaveric dissection
ConclusionThe ETPA represents a lateral extension of the midline corridor and provides a valuable route to access the PPF/UPPS. Major landmarks for this EEA are the infraorbital canal, sphenopalatine foramen, and vidian nerve. It comprises the removal of the palatine bone, posterior wall of the maxillary sinus, and PPF transposition to drill the pterygoid process. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 4, 2020 Category: Neurosurgery Source Type: research

Changes in intracranial pressure and pulse wave amplitude during postural shifts
AbstractBackgroundMonitoring of intracranial pressure (ICP) and ICP pulse wave amplitude (PWA) is an integrated part of neurosurgery. An increase in ICP usually leads to an increase in PWA. These findings have yet to be replicated during the positional shift from supine to upright, where we only know that ICP decreases. Our main aim is to clarify whether the positional shift also results in a change in pulse wave amplitude.MethodOur database was retrospectively reviewed for subjects having had a standardized investigation of positional ICP. In all subjects, mean ICP and PWA were determined with both an automatic and a manu...
Source: Acta Neurochirurgica - September 4, 2020 Category: Neurosurgery Source Type: research

Long-term feasibility of the new sutureless excimer laser-assisted non-occlusive anastomosis clip in a pig model
ConclusionThe SEcl technique is not inferior to the ELANA technique regarding patency, flap retrieval rate, flow, and endothelialization. On the basis of a significantly shorter application time and superior hemostasis, the SEcl technique could be preferable over the ELANA technique. A pilot study in patients is a logical next step based on our current results. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 2, 2020 Category: Neurosurgery Source Type: research

Free-hand stereotactic ventricular catheter insertion technique based on radio-anatomical landmarks. How I do it
ConclusionThis simple and cost-effective method improves VC insertion accuracy. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 2, 2020 Category: Neurosurgery Source Type: research

Comorbid depression associated with non-routine discharge following craniotomy for low-grade gliomas and benign tumors – a nationwide readmission database analysis
ConclusionDepression is prevalent in patients with LGG and BBT and is associated with increased risk of non-routine discharge following surgical intervention. The increased likelihood of non-routine disposition is greater for males than that for females. Awareness of the risk factors for depression may aid in early screening and intervention and improve overall patient outcomes. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 2, 2020 Category: Neurosurgery Source Type: research

Empirically adapted or personalized antibiotic prophylaxis in select cranial neurosurgery?
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 2, 2020 Category: Neurosurgery Source Type: research

The battle against an invisible enemy
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 2, 2020 Category: Neurosurgery Source Type: research

The Danish Chronic Subdural Hematoma Study —comparison of hematoma age to the radiological appearance at time of diagnosis
ConclusionIn this large national cohort, patients with membranous CSDH had a significantly longer interval between head injury and diagnosis compared to other radiological subtypes. This indicates that the radiological appearance of CSDH evolves over time, causing an alteration from different early radiological subtypes to a radiological subtype with membranes.Clinical trial registration numberThe study was approved by the Danish Data Protection Agency (journal no.30-1145). (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

Volumetric analysis of bilateral spinal canal decompression via hemilaminectomy versus laminoplasty in cervical spondylotic myelopathy
ConclusionsOur study reveals that OLD can yield a comparable extent of decompression to laminoplasty in CSM while also delivering statistically significant clinical improvement. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

Novel method to evaluate the risk of tumor adhesions and post-operative hemorrhage of meningiomas using 320 row CT-DSA: A clinical research study
ConclusionA 320-row dynamic contrast CT scanner can detect meningiomas with a high probability of severe adhesion toward the brain surface and postoperative intraparenchymal hematoma. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

Cerebrospinal fluid levels of GFAP and pNF-H are elevated in patients with chronic spinal cord injury and neurological deterioration
ConclusionsThe present findings suggest that in patients with spinal cord tethering, CSF GFAP and pNF-H levels might reflect ongoing scar formation and neuronal injury potentially responsible for progressive neurological deterioration. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

Presence of vasa vasorum in human intracranial aneurysms
ConclusionsThe presence of vasa vasorum is common in IAs. While it is associated with aneurysm wall remodeling and robust inflammatory cell infiltration, our results indicate that it is not a single specific marker of rupture-prone aneurysms. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

Predictors of deep-vein thrombosis in subarachnoid hemorrhage: a retrospective analysis
ConclusionElevated d-dimer level at the time of hospitalization, motor deficit, and the presence of an intraparenchymal hemorrhage are independent risk factors for deep-vein thrombosis. Patients with DVT also had a significantly longer hospital stay. Even though further studies are needed, patients with elevated d-dimer at hospitalization and intraparenchymal cerebral hemorrhage may benefit from a more aggressive screening strategy for deep-vein thrombosis. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

The membrane of Liliequist —a safe haven in the middle of the brain. A narrative review
ConclusionFurther standardized anatomical studies are needed to clarify the relation of the membrane of Liliequist with surrounding structures but also the anatomy of the arachnoid membranes in general. Our study supports this endeavour by identifying the knowledge hiatuses and reviewing the current knowledge base. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

Clinical and morphological risk factors for the recurrence of anterior communicating artery aneurysms after clipping or coiling
ConclusionsThe results of this study demonstrated that coiling, large aneurysm, anterior direction, and smoking history may be independent risk factors for the recurrence of AcomA aneurysms. Therefore, careful follow-up should be needed especially in large AcomA aneurysms with anterior direction after coiling. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

Drain type and technique for subdural insertion after burr hole evacuation of chronic subdural hematoma
AbstractStrengths and limitations of subdural versus subperiosteal drain location after burr hole evacuation of chronic subdural hematoma (CSDH) are currently debated. The safety of subdural placement of a drain has been questioned in a recent study by Soleman et al. from 2019, showing a misplacement rate of 17%, and these results have been further highlighted by the same authors, with a slightly lower misplacement rate of 15.8%, in the recent paper “When the drain hits the brain.” The safety of subdural drainage for CSDH depends to a high degree on type of drain and surgical technique. In this technical note, ...
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

Uncertainty, systemic bias, and their clinical implications in Gamma Knife surgery dose planning
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

Minimally invasive posterior percutaneous transarticular C1 –C2 screws: how I do it
We present a 69-year-old woman, who was diagnosed with a C2 Odontoid fracture type III and primarily treated with conservative treatment and collar. During first 2  weeks of follow-up, the patient developed cervical pain associated with C1–C2 instability. A minimally invasive posterior C1–C2 transarticular screw instrumentation with a percutaneus approach was performed.Results and conclusionMinimally invasive approach with tubular transmuscular approach for C1 –C2 transarticular screws instrumentation is safe and effective for C1–C2 instability. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

Letter: embolization of the middle meningeal artery in patients with chronic subdural hematoma —a systematic review and meta-analysis
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research