Use of fenestrated aneurysm clips in microvascular decompression surgery
Bibliographic record
Abstract
/The standard techniques of microvascular decompression (MVD) surgery in which implant materials such as shredded Teflon felt are used may be inadequate in some complex cases. The authors evaluated the use of fenestrated aneurysm clips to maintain transposition of culprit vessels in patients with trigeminal neuralgia (TN) and hemifacial spasm (HFS). The authors conducted a retrospective review of MVD operations in which the culprit vessel was transposed and then maintained in position with a fenestrated aneurysm clip secured in position by suturing it to the dura mater. Among a consecutive series of more than 450 MVD surgeries, the fenestrated aneurysm clip sling was used in eight of the last 100 cases: six for HFS and two for TN. The follow-up period ranged from 1 to 13 months, and complete symptom resolution was noted in seven of the eight patients. No patient exhibited evidence of any surgical complications. This approach can be safely performed in complicated MVD cases such as reoperations and transpositions of long ectatic arteries. To the best of the authors' knowledge this is the first report in which the use of fenestrated aneurysm clips in MVD surgery is described.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".