In patients with refractory traumatic intracranial hypertension, decompressive craniectomy resulted in lower mortality but higher proportions of vegetative state and severe neurological impairment compared to ongoing medical management. Level of evidence: 1B (CEBM, Individual RCT of good quality)

This true frameless stereotactic biopsy technique was associated with low morbidity and mortality rates and an excellent diagnostic yield, with overall results at least as good as those observed for frame-based stereotaxy. The excellent accuracy results demonstrated previously and statistically significant reductions in operative time, as well as improved image presentation, target selection, and simplicity, support the use of this frameless stereotactic technique in preference to frame-based biopsy techniques.

Although this was not a randomized study, the analysis of these results strongly suggests a positive effect of neuronavigation on the complication rate and thus on intensive care unit and hospital stays, with attendant financial implications.

In this report, we present two cases using a novel flow diverter, the Silk Vista Baby, to treat aneurysms successfully, both ruptured and unruptured, that would have been difficult to treat using alternative flow diverters. We describe the clinical and radiological features, outcome and the unique features of the Silk Vista Baby flow diverter.