• Some studies showed a higher rate of shunt obstruction in patients undergoing VA shunting.
• Other studies demonstrated no difference in terms of shunt obstruction.
• In general, no difference was reported between VA and VP shunting regarding the rates of complications and mortality.
Plain Language Summary 
For management of hydrocephalus, we usually use Ventriculoperitoneal (VP) or Ventriculoatrial (VA) shunts that drain CSF (cerebrospinal fluid ) in the abdominal cavity or heart, respectively. CSF shunting is the most popular operation in the field of pediatric neurosurgery. Shunt obstruction and shunt infection are the most important complications of the shunting process. The provision of a safety profile for shunting in the treatment of hydrocephalus patients is very important. This study aimed to determine the success rates and complications of VP and VA shunting in patients with hydrocephalus. Some studies reported a higher rate of shunt obstruction in patients undergoing VA shunting; however, other studies demonstrated no difference in terms of shunt obstruction. In general, no difference was reported between VA and VP shunting regarding the rates of complications and mortality. Due to the ease of placement and revision, VP shunting could be considered the first-line treatment for hydrocephalus. However, this approach has been preferred in newborns, and there have been insufficient data on adults in this regard.

• The transcranial approach is effective when resection of a pituitary macroadenoma cannot be done with the transsphenoidal route.
• Microscopic transsphenoidal surgery due to limitation of the endoscopic approach is suitable in pediatric patients and avoided wide anatomical deficit. 
• For selecting suitable EETA as META or BETA or OETA, the size and consistency of tumor, general versus invasive pituitary adenoma, and the extent of parasellar and suprasellar extension is essential. 
Plain Language Summary 
Endoscopes create a good and extensive visualization of the surgical field. There are three types of transsphenoidal endoscopic approach to pituitary adenoma as: mononostril, binostril, and one and a half nostril. The main difference between these three approaches is the different ways to remove the nasal septal mucosa. From the technical viewpoint, the mononostril approach is a two-hand technique, and the binostril and one and a half nostril approach can be a three-hand or four-hand technique. We compared these three approaches and techniques and consider the short-term and long-term outcomes, benefits, and complications of these three approaches for pituitary adenoma surgery.

• All patients with carpal tunnel syndrome with axonal degeneration in needle EMG of abductor pollicis brevis (APB) muscle showed abnormal amplitude loss during median nerve stimulation at the palm.
• The sensitivity and specificity of recording median nerve amplitude with stimulation at palm were 73% and 100%, respectively.
• The sensitivity and specificity of recording median nerve amplitude with stimulation at the wrist were 86.6% and 94.9%, respectively.
Plain Language Summary 
In this project, we intend to investigate whether median nerve stimulation at the palm and wrist could accurately detect axonal loss in patients with Carpal Tunnel Syndrome (CTS) similar to Electromyography (EMG) on the Abductor Pollicis Brevis (APB) muscle. In this regard, we studied 180 patients with CTS referred to the Electrodiagnostic (EDX) Center at Poursina Hospital, Guilan Province, Iran, between 2018 and 2019. We determined the signs of axonal loss in the patients using two tests, including median nerve stimulation at palm and wrist. We compared the results of these tests with EMG outputs for APB as a gold standard to clarify the sensitivity and specificity of two tests to diagnose axonal loss in CTS patients. Our findings showed that an abnormal amplitude loss during median nerve stimulation at palm like the axonal loss diagnosed by EMG of APB was observed in all patients. We estimated the sensitivity of 73% and 86% and the specificity of 100% and 94.9% for median nerve stimulation at palm and wrist, respectively. As a result, we found an abnormal amplitude loss during median nerve stimulation at palm that could be a good indicator for diagnosing axonal loss in CTS patients. This test might be used instead of the EMG of APB.

● Real-time 3D hand-made ICG angiography is applicable for displaying vessels. 
● Real-time 3D ICG angiography helps with a better understanding of the vascular anatomy.
● Our constructed device achieved acceptable 3D image quality and is highly promising for further development.
Plain Language Summary 
Indocyanine Green (ICG) angiography has become the standard of practice in many centers. we designed and constructed an ICG angiography camera to display real-time 3D ICG angiographies. Our project had three phases. We developed a 3D ICG camera to demonstrate 3D ICG angiographies in real-time. We successfully completed all three phases of the project. We proposed a method and proved its feasibility for producing a 3D ICG angiography camera to be mounted on the next generation of neurosurgical microscopes.

• Eighteen patients with spinal metastases from gynecological cancer were included in the study.
• Mechanical pain relief, spinal stability, and improvement of neurological function were observed.
• There was a positive correlation between pre-operative ambulatory status and overall survival.
Plain Language Summary 
Gynecological cancer has a high incidence worldwide. Eventually this type of cancer can progress with metastases, such as spinal metastases. However, spinal metastasis from gynecological cancer is rarely reported, which shows the importance of studies about this condition. Herein, the authors analyzed the prognostic factors related to this pathology, such as global survival and surgical results. The authors performed a literature review and an analysis of 18 medical records of patients submitted to decompressive surgery plus radiotherapy in the Department of Neuro-Oncology at a cancer hospital in Brazil. The evaluation of preoperative and postoperative condition was performed using specific scores and scales. In relation to the patients’ characteristics, the most common type of cancer was cervical cancer (n=12, 66.6%) and the vertebral regions most affected by metastases were lumbar (n=30; 50.0%). Even though decompressive surgery promotes pain relief and improvement in the quality of life for patients with spinal metastasis from gynecological cancer, the prognosis is poor, with low survival rate. The disease affects, mainly, patients of advanced age. Therefore, the decision-making process to select appropriate patients for the surgical procedure treatment must measure the possibility of positive outcomes.

• Microsurgical clipping of ruptured anterior circulation aneurysms in good grade patients is generally safe, but almost 10% of them were rendered dependent due to surgical insult alone. 
• A direct vascular injury like intraoperative rupture resulting from faulty clip placement was the culprit in 4%, while another 4% suffered from inadvertent parent vessel inclusion in the clip.
• The use of rigid retractors was faced with direct brain damage leading to brain contusion in 2% of cases emphasizing dynamic retraction as a safer option.
Plain Language Summary 
Bulging or ballooning of the artery due to weakness in the vessel wall that supplies blood to the brain is termed “cerebral aneurysm”. The weakness of the vessel wall is prone to rupture, leading to blood spreading in subarachnoid space, which may extend to adjacent parenchyma and/or ventricles and can be life-threatening. The carotid artery and vertebral artery on each side are the chief vessels supplying blood to the brain. The carotid system is referred to as anterior circulation, while the vertebral system makes posterior circulation. The affected patients are usually in their fourth to sixth decade of life with a female preponderance. Acute rupture calls for intensive care admission, stabilization, and assessment regarding the severity of the bleeding. This assessment involves clinical examination as well as imaging like brain scan and angiography of brain vessels. Patients are then graded according to their clinical well-being as good, bad, or worse. Cerebral angiography helps define that whether the affected vessel belongs to anterior or posterior circulation. It also provides a roadmap to select the treatment modality best suited for an individual case. Both open surgery and endovascular treatment options exist for most cases. Although open surgery is invasive, clipping the neck of an aneurysm is the definitive treatment. Good-grade patients of anterior circulation ruptured aneurysms, who have no pre-operative focal neurological deficits (WFNS I & II), are expected to stay independent following clipping, but oftentimes they do not. Here, we aim to look at the surgical risk factors leading to developing dependency in previously independent patients, thereby focusing only on the impact of surgical expertise available in a resource-limited setup. Vascular injuries in the form of parent vessel occlusion leading to early infarct, intraoperative rupture, and direct brain damage due to rigid retractor were the culprits.

• In COVID-19 disease, in addition to respiratory symptoms, some patients have symptoms of the central nervous system.
• Stroke, cerebral sinus vein thrombosis, and cerebral hemorrhage have been reported in patients with COVID-19.
• SARS-CoV-2 virus disrupts the regulation of blood pressure by binding to Angiotensin-Converting Enzyme 2 (ACE2) receptors in brain tissue.
• This imbalance reduces the conversion of angiotensin 2, a vasoconstrictor, to angiotensin 1-7, a vasodilator.
• This reduction results in increased cerebral blood pressure and cerebral hemorrhage in older adults.
Plain Language Summary 
This notion that SARS-COVID 2 virus only affects the respiratory system is incorrect because the virus can affect other systems, such as the heart and brain. Common symptoms of infection with the virus include high fever, cough, body aches, and shortness of breath. But other symptoms, such as a low level of consciousness, especially in adults, should be considered because this symptom can signify that the SARS-COVID 2 virus has entered the brain. In our study, an older person was admitted to the hospital with a low level of consciousness without other symptoms of COVID- 19 disease. After the examinations, the images of the lungs showed that the patient was suspected of COVID-19 disease, and after the test, the result was positive. Brain imaging also showed cerebral hemorrhage. As the SARS-COVID 2 virus enters the brain cells through the bloodstream or olfactory system, the mechanisms involved in maintaining the balance of blood pressure are disrupted, and blood pressure rises. In the elderly, rupture of arteries and intracerebral hemorrhage may occur due to decreased elasticity of the vessel wall. In the elderly, care should be taken to reduce the low of consciousness, and the patient should be examined for COVID-19 disease to prevent the transmission of the disease to others and the complications of the disease that can threaten the lives of the elderly.

• Public awareness of the importance of preventing violent behavior should be raised.
• Extraction can prevent worsening damage to vital structures.
• Reasonable radiological interpretation allows choosing a safe surgical procedure.
Plain Language Summary 
Stabbing orbitocranial trauma has serious consequences for the patient’s vision, brain, and life. It is a surgical emergency. Our case was admitted for neuro-ophthalmological emergencies. After careful physical examination of the patient, the physician recommended blood tests and x-ray to assess the condition of the eye, bone, brain, and the relationship of the foreign body to the anatomical structures. Magnetic resonance imaging is contraindicated in this type of trauma. Treatment consisted of the extraction of the foreign body without adding any other lesions. The results depend on the severity of the lesions and the patient’s clinical condition. To prevent this type of accident, violence must be prohibited by reducing the availability and harmful alcohol consumption and reduce access to bladed weapons.