Cerebrospinal Fluid Homeostasis and Hydrodynamics: A Review of Facts and Theories.

Background And Purpose: According to the classical hypothesis, the cerebrospinal fluid (CSF) is actively secreted inside the brain's ventricular system, predominantly by the choroid plexuses, before flowing unidirectionally in a cranio-caudal orientation toward the arachnoid granulations (AGs), where it is reabsorbed into the dural venous sinuses. This concept has been accepted as a doctrine for more than 100 years and was subjected only to minor modifications. Its inability to provide an adequate explanation to questions arising from the everyday clinical practice, in addition to the ever growing pool of experimental data contradicting it, has led to the identification of its limitations.

Long-term Outcome Following Three-Level Stand-Alone Anterior Cervical Discectomy and Fusion: Is Plating Necessary?

Background: Anterior cervical discectomy with fusion (ACDF) is a proven method for the treatment of selected patients. The necessity of use of an anterior plate is controversial. The article aims to assess the fusion rates (FRs) and long-term outcomes following three-level ACDF.

Pedicle screw placement accuracy impact and comparison between grading systems.

Background: Pedicle screw instrumentation is widely used for spinal stabilization. However, the accuracy for free-hand screw placement ranges from 69% to 94%. This study assesses the value of the existing classification systems, and investigates their impact on the ability to assess the accuracy of free-hand screw placement.

Local intra-arterial eptifibatide for intraoperative vessel thrombosis during aneurysm coiling.

We report on our experience with the intra-arterial administration of eptifibatide for thrombolysis during aneurysm-embolization procedures. In 4 cases (3 stent-assisted coiling procedures and 1 with posthemorrhagic vasospasm), we noted the formation of thrombus occluding a vessel. We administered eptifibatide (10-15 mg) through a microcatheter proximal to the thrombus.

A case report of a family with 7 patients of the Von Hippel-Lindau disease.

Background: This study presents a family with hereditary cerebellar hemangioblastomas, as manifestations of the VHLD.

Methods: In a 20-year period, 7 members of a family, in 3 generations, developed symptoms of the VHLD with very high frequency and gene penetration. Six patients were operated for cerebellar hemangioblastomas.