A Comprehensive Training Model for Simulation of Intracranial Aneurysm Surgery Using a Human Placenta and a Cadaveric Head.

Background And Objectives: Aneurysmal surgery is technically complex, and surgeon experience is an important factor in therapeutic success, but training young vascular neurosurgeons has become a complex paradigm. Despite new technologies and simulation models, cadaveric studies still offer an incomparable training tool with perfect anatomic accuracy, especially in neurosurgery. The use of human placenta for learning and improving microsurgical skills has been previously described.

Using Smartphones for Clinical Assessment in Cervical Spondylotic Myelopathy a Feasibility Study.

Degenerative cervical myelopathy (DCM) is characterized by a progressive deterioration in spinal cord function. Its evaluation requires subjective clinical examination with wide interobserver variability. Objective quantification of spinal cord function remains imprecise, even though validated myelopathy-grading scales have emerged and are now widely used.

Endoscopic Transfontanellar Approach of a Cyst Anterior to the Brainstem Crossing the Foramen Magnum-Part I: Failure of Unique Fenestration: 2-Dimensional Operative Video.

Premature infants with severe germinal matrix intraventricular hemorrhage (IVH) are at high risk of posthemorrhagic ventricular dilation and hydrocephalus (Video 1). We report the case of a 3-month-old premature infant referred for posthemorrhagic multilocated hydrocephalus. He presented with somnolence, hypotonia, and a bulging fontanelle.

Endoscopic Transfontanellar Approach of a Cyst Anterior to the Brainstem Crossing the Foramen Magnum-Part II: Success of Multiple Fenestrations: Two-Dimensional Operative Video.

Premature infants with severe germinal matrix/intraventricular hemorrhage are at high risk of posthemorrhagic ventricular dilation and hydrocephalus (Video 1). We report a 4-month-old premature infant with grade III intraventricular hemorrhage and compartmentalized hydrocephalus with an unusual craniospinal cyst. The cyst extended anteriorly from the mesencephalon to the posterior wall of C6, causing severe compression of the brainstem and spinal cord.

Indications, Techniques, and Outcomes of Robot-Assisted Insular Stereo-Electro-Encephalography: A Review.

Stereo-electro-encephalography (SEEG) is an invasive, surgical, and electrophysiological method for three-dimensional registration and mapping of seizure activity in drug-resistant epilepsy. It allows the accurate analysis of spatio-temporal seizure activity by multiple intraparenchymal depth electrodes. The technique requires rigorous non-invasive pre-SEEG evaluation (clinical, video-EEG, and neuroimaging investigations) in order to plan the insertion of the SEEG electrodes with minimal risk and maximal recording accuracy.

Reversible Focal Dystonia Secondary to Giant Perivascular Spaces.

Giant perivascular spaces (PVS) are rare, CSF-filled, dilated cavities lined by the pia mater that are most often asymptomatic radiological findings but can sometimes cause neurological symptoms. We present two exceptional cases of secondary focal dystonia induced by the mass effect on the basal ganglia caused by giant diencephalic PVSs. In both cases, we chose a surgical stereotactic drainage approach as a treatment strategy that allowed controlling the movement disorders.

Foot Drop After Iliocaval Vein Stenting: Radicular Syndrome from Stent Misplacement in Spinal Canal.

Background: Endovascular procedures have become more and more prevalent in both general vascular and neurosurgical practices. Because these procedures rely on real-time bidimensional control through fluoroscopic guidance, they can be prone to spatial misplacement in the third dimension when not controlled in 2 different radiologic planes.

Case Description: We report a unique complication of an iliocaval vessel stenting procedure with misplacement of a venous stent in the spinal canal.

Pulse generator battery life in deep brain stimulation: out with the old… in with the less durable?

Background: Battery life of the most commonly used implantable pulse generators in deep brain stimulation is limited. Device replacement is costly and may expose patients to additional risks. Driven by the observation that in our experience newer generation devices seemed to need earlier replacement than the older generation, we aimed to retrospectively analyze the battery life of two generations of non-rechargeable devices, manufactured by a single company (Medtronic, USA).

Multilevel Pedicular Osteotomies for En Bloc Resection of a Primary Ewing Sarcoma of the Subaxial Cervical Spine with Pedicle Screw Reconstruction.

Background: Primary Ewing sarcoma of the mobile spine is a rare disease. Its management requires careful surgical planning, because radical, margin-free excision is directly correlated with prognosis. Extensive bone removal in the cervical spine can lead to instability and cause postoperative iatrogenic cervical deformity.

Rupture of a concealed aneurysm after intravenous thrombolysis of a thrombus in the parent middle cerebral artery.

Background: Management of ischemic stroke in the presence of aneurysmal brain disease is controversial. Recent retrospective evidence suggests that in selected patients, intravenous thrombolysis (IVT) remains a safe approach for reperfusion.

Methods: We document a case of post-thrombolysis aneurysmal rupture.

Delayed presentation of deep penetrating trauma to the subaxial cervical spine.

Purpose: To present a rare case of deep penetrating neck trauma in which a retained foreign body in the cervical spine (a broken knife blade) resulted in delayed radicular injury. We describe the surgical management using a retrojugular approach.

Case Report: Our patient sustained a stab wound to the supraclavicular triangle from a small pocketknife.

MicroRNA-22 (miR-22) overexpression is neuroprotective via general anti-apoptotic effects and may also target specific Huntington's disease-related mechanisms.

Background: Whereas many causes and mechanisms of neurodegenerative diseases have been identified, very few therapeutic strategies have emerged in parallel. One possible explanation is that successful treatment strategy may require simultaneous targeting of more than one molecule of pathway. A new therapeutic approach to have emerged recently is the engagement of microRNAs (miRNAs), which affords the opportunity to target multiple cellular pathways simultaneously using a single sequence.

Highlights of the Keystone Symposium: sirtuins in metabolism, aging and disease.

From February 12-16, 2012, leading members of the sirtuin scientific community assembled in Tahoe, CA to attend the Keystone Symposium "Sirtuins in Aging, Metabolism, and Disease." It was a vibrant and lively meeting, and in the spirit of Keystone Symposia, both established sirtuin researchers and those new to the field enjoyed a unique opportunity to interact and exchange ideas.