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Origins of Wilder Penfield's surgical technique

The role of the “Cushing ritual” and influences from the European experience

Mark C. Preul and William Feindel

A s with the earlier generation of pioneer neurosurgeons at the beginning of the 20th century, Wilder Penfield (1891–1976) developed his surgical technique largely on his own initiative. 18 As he had worked out his own education in neurophysiology and neuropathology, so too he organized the development of his surgical technique and the eventual formation of a distinct neurosurgical school. 6, 10, 20 Penfield used Cushing's operative technique as a “sort of classic” and “constantly referred to the general principles which he laid down in neurosurgical

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Soichi Oya, Burak Sade, and Joung H. Lee

arduous challenge, and the benefit of radiation therapy alone is often limited because of the proximity to the optic nerve. 1 , 18 Some recent series reported on the strategy of resection in conjunction with postoperative radiation. 20 , 22 , 27 , 28 The feasibility of radical resection has been debated. In our opinion, the key to achieving favorable surgical outcome is safe and strategic drilling of the hypertrophied skull base structures. In this study, we describe our surgical technique for SOMs in detail and report the outcome of our series. Methods

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Antonio Gonçalves-Ferreira, Alexandre Rainha Campos, Manuel Herculano-Carvalho, Jose Pimentel, Carla Bentes, Ana Rita Peralta, Carlos Morgado, and The Epilepsy Surgery Group

that disconnecting the epileptic zone is equivalent to resecting it, provided that no expanding lesions are concerned. Therefore, our main objective in the present work was to describe the surgical technique and long-term postsurgical outcome (2-year follow-up) in a series of patients with MTLS who underwent amygdalectomy and hippocampal disconnection (hippocampotomy) or amygdalohippocampotomy (AHCo), rather than its excision (hippocampectomy), and to compare these data with findings in patients treated via conventional amygdalohippocampectomy (AHC). Methods

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John M. Mesa, Frank Fang, Karin M. Muraszko, and Steven R. Buchman

S uccessful repair of all abnormal characteristics of unicoronal plagiocephaly remains a challenge for craniofacial surgeons. Although the phenotypical characteristics of unicoronal plagiocephaly have been clearly described (ipsilateral supraorbital rim elevation [vertical dystopia] and retrusion, ipsilateral frontal bone retrusion, ipsilateral temporal constriction, contralateral frontal boss, contralateral temporal boss, and C-shaped deformity of the face), current surgical techniques often do not successfully achieve long-term correction of all of the

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Vittoria Nazzi, Angelo Franzini, Giuseppe Messina, and Giovanni Broggi

I n the past few years, minimally invasive surgical techniques in the treatment of CTS have become widespread compared with the open surgery technique. This is due to the reduced surgical time, the limited incidence of surgical complications (including length of incision and postoperative scarring), faster functional recovery, earlier return to work, and lower costs. Minimally invasive techniques include endoscopic CTR procedures, based on the use of a fiberoptic endoscope to examine the anatomy and length of the transverse carpal ligament and adjacent

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John H. Chi, Sanjay S. Dhall, Adam S. Kanter, and Praveen V. Mummaneni

S ymptomatic thoracic disc herniations are rare in the general population, yet they represent a distinct challenge for many spine surgeons in practice. They often cause significant radicular pain and severe, progressive myelopathy. Open surgical techniques are effective for the removal of thoracic herniated discs, and include posterolateral approaches (costotransversectomy, transpedicular, lateral extracavitary, and lateral rachiotomy) and lateral approaches (retropleural and transpleural thoracotomy). Unfortunately, to obtain adequate visualization and

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Yusuf Izci, Yusuf Tüzün, Halil Ibrahim Seçer, and Engin Gönül

particularly those involved with sheep and cattle raising. 12 Brain involvement is rare and occurs in 1–2% of all cases of hydatidosis. 6 Fifty percent to 75% of intracranial hydatid cysts are seen in children. 2–4 , 7 , 9 , 12 Because of this rarity, experience with intracranial hydatid disease at a single institution has been very limited, and the Dowling technique is widely used as a surgical treatment. 5 Preoperative and postoperative albendazole may be considered to sterilize the cyst, decrease the chance of anaphylaxis, decrease the tension in the cyst wall (thus

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Praveen V. Mummaneni, Michael G. Kaiser, Paul G. Matz, Paul A. Anderson, Michael W. Groff, Robert F. Heary, Langston T. Holly, Timothy C. Ryken, Tanvir F. Choudhri, Edward J. Vresilovic, and Daniel K. Resnick

Recommendations Indication: CSM It is recommended that a variety of techniques be considered in the surgical treatment of CSM including ACDF, ACCF, laminoplasty, laminectomy, and laminectomy with fusion (quality of evidence, Class III; strength of recommendation, D). Technique: ACDF Compared to ACCF It is recommended that ACDF or ACCF be used in patients undergoing multilevel anterior cervical spine decompression for lesions located at the disc level. The use of anterior plate fixation allows for equivalent fusion rates between these

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Moshe Attia, Felix Umansky, Iddo Paldor, Shlomo Dotan, Yigal Shoshan, and Sergey Spektor

, especially when the tumors become large or giant. These tumors usually compress, displace, or encase vital neurovascular structures in the vicinity of the ACP, such as the optic nerve, the oculomotor nerve, and the ICA and its branches. Peritumoral edema contributes to the difficulty of resecting these deep skull base tumors. An anterior clinoidal meningioma may also extend into the cavernous sinus. The extent of removal is dependent on the surgeon's ability to safely dissect tumor from these critical structures. Several patient series describing surgical techniques and

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Giulia Cossu, Pablo González-López, Etienne Pralong, Judith Kalser, Mahmoud Messerer, and Roy Thomas Daniel

. 30 Thus, we can conclude that the main anatomical subcortical net is developed as the root for subsequent “maturation” during childhood and adolescence. The direction and relative location of the white matter fibers appear to be the same. However, big changes in fractional anisotropy, shape, and size appear to be relevant during the growing periods. We cannot fully affirm that these frontal fibers are equal in adults and children; however, the 3D orientation and connecting areas appear to be very similar, or even the same. Surgical Technique After induction of