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Maryam Rahman, Gregory J. A. Murad and J Mocco

ceasing their collaboration, some authors have reported that each held on to one half of the stereotactic apparatus, and therefore, neither was unable to use the original device again. 11 , 34 F ig . 1. Photographs of Sir Victor Alexander Haden Horsley (A) and Robert Henry Clarke (B). Reprinted from Pereira EAC et al: Neurosurgery 63: 594–607, 2008. Permission granted by Lippincott Williams & Wilkins. F ig . 2. Photographs of Horsley and Clarke's stereotactic frames. Reprinted from Pereira EAC et al: Neurosurgery 63: 594–607, 2008. Permission granted

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William J. Mack, Louis J. Kim, Demetrius K. Lopes and J Mocco

techniques, and new device technologies continue to shape a rapidly expanding and evolving field. This issue of Neurosurgical Focus aims to deliver an overview of the latest developments in acute stroke care. Articles provide the reader with information and insight into advances along the entire clinical-translational spectrum—from basic science and novel animal models to clinical implementation and stroke systems of care. The first set of articles provides an in-depth review of neuroprotective strategies and their potential utility as adjuncts to mechanical

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Maryam Rahman, Gregory J. Velat, Brian L. Hoh and J Mocco

and devices, direct thrombolysis and thrombectomy without a craniotomy is becoming increasingly common. 70 , 80 Endovascular treatment of CVST has the potential advantages of acute dissolution of clot, allowing normalization of blood flow, decreased ICP, and rapid improvement of severe symptoms. Conversely, these invasive procedures are also associated with risks such as hemorrhage, vessel dissection, and pulmonary embolism. 24 , 91 We review the techniques and indications for endovascular treatment of CVST. Methods We searched the PubMed database for

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J Mocco, Ricardo A. Hanel, Jitendra Sharma, Erik F. Hauck, Kenneth V. Snyder, Sabareesh K. Natarajan, Italo Linfante, Adnan H. Siddiqui, L. Nelson Hopkins, Alan S. Boulos and Elad I. Levy

used similar stent systems with comparable technical profiles and delivery systems, manufactured by the same company (Wingspan and Neuroform stent systems, Boston Scientific). The Wingspan system is intended for intracranial stenosis treatment and the Neuroform system for aneurysm neck reconstruction. Recently, a new self-expanding stent has become available to the endovascular community, the Enterprise Vascular Reconstruction Device (Codman Neurovascular/Cordis Corp.). This device uses a catheter-based delivery system that has been suggested to provide improved

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Maryam Rahman, Gregory J. A. Murad, Frank Bova, William A. Friedman and J Mocco

The LINAC is now the most frequently used device for delivery of conventional radiotherapy and radiosurgery. Radiosurgery is truly minimally invasive, delivering therapeutic energy to an accurately defined target without an incision. It has been used in the treatment of a wide variety of pathological conditions, including benign and malignant brain tumors, vascular lesions such as arteriovenous malformations, and pain syndromes such as trigeminal neuralgia. Radiosurgery is also being studied for the treatment of movement disorders and epilepsy. A tremendous amount

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Haitham Dababneh, Waldo R. Guerrero, Anna Khanna, Brian L. Hoh and J Mocco

angiography demonstrating TIM occlusion with perfusion deficit, 3) received intravenous systemic thrombolysis, 4) underwent ICA balloon angioplasty, and 5) underwent subsequent MCA mechanical thrombectomy in which an aspiration retrieval device was used. Neither patient had evidence of hemorrhage on initial or postprocedure noncontrast head CT scan. The patients' demographics, pre– and post–endovascular intervention NIHSS score, and mRS score at 60 days are summarized in Table 1 . TABLE 1: Summary of patient demographics * Case No. Age

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Richard C. E. Anderson, Brian T. Ragel, J Mocco, Leif-Erik Bohman and Douglas L. Brockmeyer

(five screws), C-1 lateral mass screws (four), C-2 pars screws (three), and C-2 translaminar screws (one) ( Table 1 , Cases 1–6). Instrumentation for patients with occipitocervical fixation included several types of rigid occipital devices (for example, U-loop, rods, occipital plates, and so on) secured to the cervical spine with combinations of C1–2 transarticular screws (10 sides), C-1 lateral mass screws (seven), C-2 pars screws (21), and subaxial lateral mass screws (six) ( Table 1 , Cases 7–25). One patient underwent a combination anterior–posterior approach. The

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Christoph J. Griessenauer, Christopher S. Ogilvy, Paul M. Foreman, Michelle H. Chua, Mark R. Harrigan, Christopher J. Stapleton, Aman B. Patel, Lucy He, Matthew R. Fusco, J Mocco, Peter A. Winkler, Apar S. Patel and Ajith J. Thomas

T he flow-diverting Pipeline Embolization Device (PED) (Covidien-ev3) results in the occlusion of intracranial aneurysms by disrupting blood flow into the aneurysm, leading to thrombosis followed by luminal reconstruction of the parent artery. Of concern is the preservation of the perforating arteries and side branches covered by the PED. Multiple factors govern aneurysm occlusion and branch preservation. As opposed to the aneurysm itself, the pressure gradient between the parent vessel and its branches creates an aspiration effect that allows for the

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Roberta K. Sefcik, Nicholas L. Opie, Sam E. John, Christopher P. Kellner, J Mocco and Thomas J. Oxley

discusses possible future applications of endovascular EEG in minimally invasive neurosurgery in the fields of epilepsy, DBS, and BMI. Technical Progress: A Historical Timeline The following timeline demonstrates the technical developments achieved in the recording of endovascular EEG from the first recordings in the early 1970s 23 to the most recent recordings in 2015. 22 The technical progress in device development, from wire electrodes to nanowire and catheter electrodes and finally stent-electrodes (stentrodes), is described. Wire Recordings

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Haitham Dababneh, V. Shushrutha Hedna, Jenna Ford, Ziad Taimeh, Keith Peters, J Mocco and Michael F. Waters

signal hyperintensity in the left basal ganglia representing the final infarct core. The diffusion-weighted image shows a small area of acute restriction in the left periventricular subcortical white matter. Operation and Postoperative Course A conventional angiogram-directed Penumbra retrieval device (Penumbra Inc.) was used to gain access by canalizing the femoral artery with a 6 Fr sheath, and a 90-cm guiding catheter was used and advanced via the left internal carotid artery to the M 1 segment, where the thrombus was evacuated. The aspiration catheter