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Shigeya Tanaka, Koichi Uetsuhara, Tetsuzou Tomosugi, Kouichi Moroki, Masahiko Yamada, Hideshi Toujou, Hideo Kawakami and Munetoshi Sameshima

R ecise preoperative localization of brain lesions can assist the neurosurgeon in determining the best operative approach. We have developed a marking device that can be used with magnetic resonance (MR) imaging—guided localization of brain lesions. Description and Use of the Device The marking device was created from a circular acrylic plate 10 cm in diameter and 1.5-cm thick. Seventeen holes, × mm in diameter, were drilled in the shape of a cross at 1-cm intervals, filled with oil, and covered with acrylic lids. A sponge board 1-cm thick was attached

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Purvee D. Patel, Nohra Chalouhi, Elias Atallah, Stavropoula Tjoumakaris, David Hasan, Hekmat Zarzour, Robert Rosenwasser and Pascal Jabbour

I n recent years, the Pipeline embolization device (PED) has gained popularity as a treatment option for intracranial aneurysms. This flow diverter is an endoluminal, self-expanding, braided mesh tube made with 48 strands of platinum-tungsten and cobalt-chromium-nickel alloy wires. 5 , 54 It works by diverting blood flow away from the aneurysm, leading to thrombosis of the aneurysm while also maintaining patency of the parent vessel. 54 The device has proven to be a safe and effective therapy for large, giant, and complex intracranial aneurysms. 38 In a

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Alberto Aiolfi, Desmond Khor, Jayun Cho, Elizabeth Benjamin, Kenji Inaba and Demetrios Demetriades

Foundation guidelines recommend ICP monitoring in patients with a Glasgow Coma Scale (GCS) score < 9 and an abnormal head CT scan or in patients with a normal CT scan who meet 2 of the following 3 criteria: age > 40 years, motor posturing, and systolic blood pressure < 90 mm Hg. 2 Various devices have been used for monitoring ICP, most commonly an intraventricular device (IVD) or an intraparenchymal device (IPD). These 2 types of devices require different insertion techniques and have different therapeutic capabilities. Despite the widespread use of these monitors, very

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Keisuke Imai, Hiroyuki Komune, Chiaya Toda, Takeru Nomachi, Eiji Enoki, Hiroaki Sakamoto, Shohei Kitano, Mitsuo Hatoko and Takuya Fujimoto

T here are many reports on the successful lengthening of the midfacial bone, assisted by distraction-induced osteogenesis, but relatively few on cranial vault distraction for craniosynostosis. Preoperative planning for gradual distraction of the cranial vault is difficult because of the 3D flexibility of calvarial bones along the vectors of distraction. Selecting the device to be used and the path of the osteotomy line thus becomes crucial. At our hospital, we have achieved success by performing frontoorbital advancement and cranial remodeling assisted by

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Ralf A. Kockro, Rainer Giacomelli, Martin Scheihing, Alfred Aschoff and Juergen A. Hampl

while the other was in use). In addition, the usual methods of head fixation are time consuming and require profound analgesia, which increases the risk of anesthesia-related complications. In order to circumvent these limitations and also to accommodate the device to our surgical technique of catheter implantation and subsequent infection, we developed a stereotactic frame that uses the intraoperative contact surface of the mandible together with the coronal and sagittal sutures as stereotactic spatial reference points. Three identical frames were built and used in a

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Donald L. Erickson

T he psychological and sociological problems that are associated with chronic pain present an almost insurmountable obstacle to accurate patient selection for operative pain-relieving procedures. Some patients will fail regardless of what is done surgically. Other patients will respond positively for a brief duration, again regardless of the procedure performed. The introduction of implantable electrical stimulating devices for chronic pain relief has in no way alleviated this selection problem. In an attempt to improve our patient selection from a social

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Daniel L. Silbergeld

reported techniques for intraoperative mapping require surgical exposure of all cortex that is to be stimulated, thus necessitating a larger craniotomy than would otherwise be desirable. A new device is described that permits intraoperative stimulation of unexposed cortex, utilizing a standard cortical stimulator 11 and strip electrodes. 12 Design of Device and Stimulation Technique A standard strip-electrode connector and cable were attached to cupped-receptacle (female) platinum connectors, which were then embedded in a Silastic block so that the center

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Letters to the Editor To The Editor Graham Martin , F.R.C.S., M.R.C.P., F.R.A.C.S. Wellington, New Zealand 1160 1161 Dearden, et al. , have found that the Leeds device for monitoring intracranial pressure (ICP) did not always produce consistent readings (Dearden NM, McDowall DG, Gibson RM: Assessment of Leeds device for monitoring intracranial pressure. J Neurosurg 60: 123–129, January, 1984). At a conference on ICP at Groningen in 1976, I presented a poster display which predicted this variability by using

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Mariangela Piano, Luca Valvassori, Emilio Lozupone, Guglielmo Pero, Luca Quilici, Edoardo Boccardi and the FRED Italian Registry Group

I ntroduction of Guglielmi detachable coils (GDCs) in the 1990s gradually changed the standard treatment approach for many cerebral aneurysms, as first-line therapy began moving from surgery to endovascular treatment. Continuous improvement of materials and devices available for endovascular treatment has progressively extended its indications, but fusiform/dissecting, large/giant, and wide-neck aneurysms have remained technically challenging and with higher treatment risk. In 2006–2007 a second major shift occurred in the treatment approach for cerebral

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Henry Hirschberg

T he desirability of locating small subcortical tumors prior to craniotomy is obvious. This knowledge allows proper placement of the scalp and cortical incision and results in a minimum of operative trauma. Various methods have been described, most of which require additional radiological studies or the use of expensive equipment. 2, 3, 5–7 A simple inexpensive technique is described for accurate transfer of the tumor location from the preoperative computerized tomography (CT) scans to the scalp. Device and Technique The device consists of a flexible