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Aneurysms that occur anywhere in intracranial except where primary aneurysms develop, are called “de novo aneurysms”. The risk factors and formation time of de novo aneurysms are not fully known. Congenital, environmental and hemodynamic factors can play a role in aneurysm development. The 43-year-old female patient was operated with the middle cerebral artery superior trunk aneurysm in our clinic. She came to us again after 17 months with a severe headache. In computed cranial tomography angiography, the middle cerebral artery superior trunk placement aneurysm was found to have a partial clip and “de novo aneurysm” was developed. She was re-operated for “de novo aneurysm”. In this study, the risk factors in development of “de novo aneurysms” were discussed in the light of literature through this patient.

Introduction Pterional craniotomy is a surgical approach frequently used in aneurysm and skull base surgery. Pterional craniotomy may lead to cosmetic and functional problems, such as eyebrow drop due to facial nerve frontal branch damage, temporal muscle atrophy, and temporomandibular joint pain. The aim was to compare the postoperative effects of our modified osteoplastic craniotomy with classical pterional craniotomy in terms of any change in volume of temporal muscle and in the degree of frontal muscle nerve damage. Materials and Methods Aneurysm cases were operated with either modified osteoplastic pterional craniotomy or free bone flap pterional craniotomy according to the surgeon's preference. Outcomes were compared in terms of temporal muscle volume and frontal muscle nerve function 6 months postoperatively. Results Preoperative temporal muscle volume in the modified osteoplastic pterional and free bone flap pterional craniotomy groups were not different (p > 0.05). However, significantly less atrophy was observed in the postoperative temporal muscle volume of the osteoplastic group compared with the classical craniotomy group (p < 0.001). In addition, when comparing frontal muscle nerve function there was less nerve damage in the modified osteoplastic pterional craniotomy group compared with the classical craniotomy group, although this did not reach significance (p > 0.05). Conclusion Modified osteoplastic pterional craniotomy significantly reduced atrophy of temporal muscle and caused proportionally less frontal muscle nerve damage compared with pterional craniotomy, although this latter outcome was not significant. These findings suggest that osteoplastic craniotomy may be a more advantageous intervention in cosmetic and functional terms compared with classical pterional craniotomy.

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The flow pattern in the aqueduct was normalised and velocity was increased compared with those of preoperative values after a successful ETV. The flow of CSF in the prepontine cistern is routinely used for ventriculostomy patency assessment. In addition, aqueduct measurements may be useful in predicting ventriculostomy patency. The physical model provides valuable insights on a possible mechanism that affected the experimental data.

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Objective: Surgical or endovascular treatment is used in the treatment of intracranial aneurysms. Recent studies have suggested that the of endovascular treatment are superior to surgery Middle cerebral artery (MCA) aneurysm is the third most common bleeding aneurysm after anterior communicating artery and internal carotid artery aneurysms. We aimed to retrospectively evaluate the microsurgical outcomes of cases operated for MCA aneurysm. Methods: Twenty cases with MCA aneurysm who accepted the microsurgical treatment option were included in this study. Data were obtained by retrospectively reviewing the clinical, radiological, and intraoperative findings, as well as postoperative morbidity and mortality of the cases. Results: In total, 23 MCA aneurysms were detected in 20 cases. In 2 cases, MCA aneurysm was detected incidentally. Microsurgical clipping was performed in 23 aneurysms. In the study, the total mortality rate was 10% and the morbidity rate was 20% in MCA aneurysms. Conclusion: It was observed that the incidence of calcification or thrombosis within the aneurysm increased and the Glasgow outcome scores at the 3rd month decreased as the width and length values of the aneurysm sac increased. In addition, presence of calcification in the aneurysm wall or thrombosis in the sac was found to be positive and strongly correlated with mortality and morbidity.

Objective: Thoracic spinal stenosis (TSS) develops as a result of decreased spinal canal volume in the thoracic spine. The prevalence of TSS is low as when compared with cervical or lumbar spinal stenosis, and conservative treatment is not effective. The present study aimed to present all surgical methods employed and their outcomes in patients diagnosed with TSS in our clinic.Methods: In this study, the data of 14 patients including three patients with single-level, nine patients with two-level, one patient with three-level, and one patient with multilevel TSS and hypophosphatemic rickets who underwent surgery due to TSS, were retrospectively evaluated using the discharge summary, surgical reports, and preoperative and postoperative radiological images.Results: The age of the patients ranged from 53 to 68 years. Of the patients included in the study, one underwent hemilaminectomy, two underwent total laminectomy, six underwent laminoplasty, and five underwent total laminectomy with fusion and posterior instrumentation. A dramatic improvement was observed in the neurological deficits existing in the preoperative period in patients who were diagnosed in the early period and underwent surgery with adequate decompression before the development of severe neurological deficits and who continued postoperative rehabilitation added to the treatment.Conclusion: Patients with TSS have an insidious clinical course manifested by upper motor neuron symptoms. Although the prevalence of TSS is low, early diagnosis and treatment are important. The results of surgery are satisfactory when adequate decompression is achieved before the clinical condition worsens.