Activity

The substrates for failure were obvious in 5/6 patients and resulted from incomplete disconnection, implying surgical inadequacy. At the mean follow-up of 30± 13.17 months (range, 13-55 months), 35 of 40 patients (87.5%) remained seizure free (Engel class Ia), including 4/6 patients who underwent redo surgery. Revision did not benefit the remaining 2 patients (Engel class III). There was no mortality.

Surgical revision is more common in hemimegalencephaly and in the early days of a surgical program. Affirmative neuroimaging improves the outcomes of subsequent revision surgery.

Surgical revision is more common in hemimegalencephaly and in the early days of a surgical program. Affirmative neuroimaging improves the outcomes of subsequent revision surgery.

Separation surgery is performed to provide a safe gap between the epidural tumor and spinal cord for postoperative stereotactic body radiotherapy (SBRT) in cases of spinal metastases. However, there is a gap in evidence regarding sufficient tumor resection in separation surgery. We describe the prognoses according to the extent of resection in separation surgery.

This retrospective study included 36 consecutive patients who underwent separation surgery and postoperative SBRT between December 2016 and December 2019 at a single center. Local control (LC), overall survival (OS), distance of separation (DS), and quality-of-life parameters were analyzed. P values <0.05 were considered statistically significant.

Patients were assigned to the aggressive resection group (ARG, n= 18) or moderate resection group (MRG, n= 18), with estimated LC and OS at 1 year of 79.0% and 75.9%, respectively. There were no significant differences between ARG and MRG in estimated LC (85.9% vs. 72.2%; P= 0.317) or OS (69.3% vs. 80.9%, P= 0.953) at 1 year. All 5 patients in MRG who developed local progression had less satisfactory tumor resection with DS <3 mm. A borderline significant difference in estimated LC at 1 year was noted between individuals with DS <3 mm and those with DS ≥3 mm (51.9% vs. 100.0%; P= 0.053) in MRG. There was no statistical difference between ARG and MRG in quality-of-life parameters.

Moderate resection of ventral dural mass did not significantly reduce patients’ prognosis in separation surgery. However, the minimal distance between the postoperative residual epidural tumor and spinal cord should be ≥3 mm.

Moderate resection of ventral dural mass did not significantly reduce patients’ prognosis in separation surgery. However, the minimal distance between the postoperative residual epidural tumor and spinal cord should be ≥3 mm.

Despite failure of the EC/IC Bypass Study Group to demonstrate effectiveness in minimizing future stroke events, superior temporal artery-medial cerebral artery (STA-MCA) bypass remains an essential treatment for complex giant intracranial aneurysms, tumors, moyamoya disease with ischemia, and atherosclerotic steno-occlusive disease with hemodynamic cerebrovascular insufficiency. The objective of this report is to describe a novel suturing technique for STA-MCA bypass that helps reduce donor-recipient anastomosis time, allowing for a well-organized systematic workflow.

Step 1 involves passing the needle of a 9-0 polypropylene suture from out-to-in on the donor vessel followed by in-to-out on the recipient vessel. Step 2 Before cutting and tying a knot as per the established method of suturing, repeat step 1 and leave the needle “parked”, creating a loop that is then cut at its proximal end. Step 3 Tie knots using the jeweler’s forceps. Repeat previous steps until there are enough throws to seal the bypass adequately.

The STA-MCA bypass serves as a principal method for flow augmentation. The technique described here allows for more efficient and organized microsurgical movements reducing vessel tissue manipulation and clamp time.

We describe a novel technique for interrupted STA-MCA bypass suturing that adds efficiency, safety, organization, and operative ease compared with the conventional method of interrupted vessel suturing.

We describe a novel technique for interrupted STA-MCA bypass suturing that adds efficiency, safety, organization, and operative ease compared with the conventional method of interrupted vessel suturing.

Shunt overdrainage is a potential complication in pediatric hydrocephalus. The addition of adjustable gravitational units to previous shunt systems has been proposed as effective management for this problem. These devices have been traditionally implanted over the occipital bone. We propose chest implantation as an easier, safer, and more stable alternative in the pediatric population, especially in those cases with parieto-occipital shunts.

This study comprises a retrospective analysis from a unicentric case series of pediatric patients affected by overdrainage and managed with adjustable gravitational valves implanted in the chest. The device implantation technique is described in detail and takes no more than 15 minutes.

Thirty-seven patients met the criteria. The mean age of implantation was 9.62 years. The mean follow-up in the series was 38 months. The mean number of pressure adjustments was 2.48. The mean “deviation angle” of the device to the longitudinal body axis was 5.8°. The complications per year of shunt were <0.02 with no disconnection of the catheters in any case during follow-up.

In our experience, chest implantation for adjustable gravitational devices was a suitable shunt modification in pediatric patients suffering from overdrainage.

In our experience, chest implantation for adjustable gravitational devices was a suitable shunt modification in pediatric patients suffering from overdrainage.

In acute ischemic stroke, patient outcomes can be improved by first-pass successful recanalization of the occluded vessel. This study investigated whether microcatheter position could influence the success of first-pass recanalization.

We retrospectively analyzed 59 consecutive acute ischemic stroke patients who underwent intra-arterial thrombectomy with stent retrievers for middle cerebral artery (M1) occlusion. Angiography findings obtained via the first pass of the microcatheter were analyzed. The microcatheter was considered to be inserted into M2 segments that gave rise to parietal arteries (M2P) if the anterior or posterior parietal artery was observed. Recanalization results were compared between patients with and without microcatheter insertion into M2P. MS-275 The angle and diameter of vessels were measured using post-procedural magnetic resonance angiography.

The rate of first-pass successful recanalization (modified thrombolysis in cerebral infarction score of ≥2b) was significantly higher in patients with microcatheter insertion into M2P than in those without (56% vs.