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In this operative video, Dr. Cohen demonstrates the frontotemporal approach for STA-MCA bypass and proximal M2 occlusion of a giant MCA aneurysm. After the bypass anastomosis is completed, the temporary clips are removed and mild bleeding from the site confirms graft patency. Cotton is used to reinforce the anastomotic...

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Neurosurgical Atlas

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87,800 просмотров • 3 месяцев назад •via X (Twitter)

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In this operative video, Dr. Cohen demonstrates a suboccipital craniotomy for proximal-to-distal PICA end-to-side anastomosis for treatment of a calcified fusiform distal PICA aneurysm. The distal temporary clip is removed, revealing backflow through the aneurysm, so a permanent curved clip is placed on the distal aneurysm segment to prevent continued filling. The remaining temporary clips are removed sequentially, with minimal bleeding at the anastomosis. Micro-Doppler and fluorescein angiography confirm good flow through the vessels, no aneurysm filling, and preserved perfusion of the fourth ventricular floor. Learn more at: #Neurosurgery #Aneurysm #DrCohen #SurgicalExcellence
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In this operative video, Dr. Cohen demonstrates a suboccipital craniotomy for proximal-to-distal PICA end-to-side anastomosis for treatment of a calcified fusiform distal PICA aneurysm. The distal temporary clip is removed, revealing backflow through the aneurysm, so a permanent curved clip is placed on the distal aneurysm segment to prevent continued filling. The remaining temporary clips are removed sequentially, with minimal bleeding at the anastomosis. Micro-Doppler and fluorescein angiography confirm good flow through the vessels, no aneurysm filling, and preserved perfusion of the fourth ventricular floor. Learn more at: #Neurosurgery #Aneurysm #DrCohen #SurgicalExcellence

Neurosurgical Atlas

19,378 просмотров • 2 месяцев назад

In this operative video, Dr. Cohen demonstrates the frontotemporal approach for clip ligation of a large calcified MCA aneurysm. A tandem clipping strategy is used with a straight fenestrated clip followed by a straight clip to close the distal and proximal aneurysm neck. Although ICG initially suggests no filling, fluorescein angiography demonstrates persistent aneurysm filling. Additional straight and fenestrated clips are placed, but calcification prevents complete closure and the sac continues to fill. Ultimately, multiple clips are required to fully exclude the partially calcified atherosclerotic aneurysm. Learn more here: #Neurosurgery #Aneurysm #DrCohen #SurgicalExcellence
1:01

In this operative video, Dr. Cohen demonstrates the frontotemporal approach for clip ligation of a large calcified MCA aneurysm. A tandem clipping strategy is used with a straight fenestrated clip followed by a straight clip to close the distal and proximal aneurysm neck. Although ICG initially suggests no filling, fluorescein angiography demonstrates persistent aneurysm filling. Additional straight and fenestrated clips are placed, but calcification prevents complete closure and the sac continues to fill. Ultimately, multiple clips are required to fully exclude the partially calcified atherosclerotic aneurysm. Learn more here: #Neurosurgery #Aneurysm #DrCohen #SurgicalExcellence

Neurosurgical Atlas

13,427 просмотров • 1 месяц назад

Bypass & flow reversal is a powerful strategy for treating giant aneurysms: it deals w/their unclippability; uses natural thrombosis to close the aneurysm completely; indicates some fancy & fun bypasses, like this side-to-side bypass w/ant. temporal artery (ATA-M2 MCA) + STA-MCA…
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Bypass & flow reversal is a powerful strategy for treating giant aneurysms: it deals w/their unclippability; uses natural thrombosis to close the aneurysm completely; indicates some fancy & fun bypasses, like this side-to-side bypass w/ant. temporal artery (ATA-M2 MCA) + STA-MCA…

Michael T. Lawton, MD

14,508 просмотров • 8 месяцев назад

In this operative video, Dr. Cohen demonstrates the supracerebellar transtentorial approach for resection of a medial tentorial meningioma. After devascularization, the tumor becomes more gelatinous and is removed with suction while posterior cerebral artery branches are protected to prevent occipital ischemia. The tumor-involved tentorium is then pulled into the resection cavity after its medial attachment is released. Smaller arachnoid bands are divided, the field is cleared, and the affected tentorial segment is removed. Final inspection shows no obvious residual tumor in the field. Learn more here: #Neurosurgery #Meningioma #DrCohen #SurgicalExcellence
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In this operative video, Dr. Cohen demonstrates the supracerebellar transtentorial approach for resection of a medial tentorial meningioma. After devascularization, the tumor becomes more gelatinous and is removed with suction while posterior cerebral artery branches are protected to prevent occipital ischemia. The tumor-involved tentorium is then pulled into the resection cavity after its medial attachment is released. Smaller arachnoid bands are divided, the field is cleared, and the affected tentorial segment is removed. Final inspection shows no obvious residual tumor in the field. Learn more here: #Neurosurgery #Meningioma #DrCohen #SurgicalExcellence

Neurosurgical Atlas

19,703 просмотров • 1 месяц назад

In this operative video, Dr. Cohen demonstrates the telovelar approach for resection of a large hypervascular vermian hemangioblastoma. The interface between the hemangioblastoma and surrounding tissue is developed with coagulation and sharp dissection. As the dissection advances deeper, bleeding risk increases, so any capsular entry is controlled with further coagulation. The tumor is operated on from deep to superficial to protect the floor of the fourth ventricle while identifying larger anterior vessels. Only vessels clearly entering the tumor are coagulated, preserving cerebellar vessels and maintaining hemostasis near the fourth ventricular floor. Learn more here: #Neurosurgery #Hemangioblastoma #DrCohen #SurgicalExcellence
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In this operative video, Dr. Cohen demonstrates the telovelar approach for resection of a large hypervascular vermian hemangioblastoma. The interface between the hemangioblastoma and surrounding tissue is developed with coagulation and sharp dissection. As the dissection advances deeper, bleeding risk increases, so any capsular entry is controlled with further coagulation. The tumor is operated on from deep to superficial to protect the floor of the fourth ventricle while identifying larger anterior vessels. Only vessels clearly entering the tumor are coagulated, preserving cerebellar vessels and maintaining hemostasis near the fourth ventricular floor. Learn more here: #Neurosurgery #Hemangioblastoma #DrCohen #SurgicalExcellence

Neurosurgical Atlas

144,636 просмотров • 1 месяц назад

In this operative video, Dr. Cohen demonstrates resection of a cavernous sinus meningioma through a frontotemporal approach. The operation proceeds through the middle fossa, where the fibrous tumor is entered inferiorly and internally debulked to create working space. As the mass is reduced, the dissection follows the lateral wall of the cavernous sinus, with continued attention to the trigeminal nerve branches as they are identified and preserved. Further opening of the lateral cavernous sinus wall allows additional tumor removal until cavernous sinus venous bleeding defines the limit of safe resection. Start your trial with the Neurosurgical Atlas today to gain access to our library of operative videos.
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In this operative video, Dr. Cohen demonstrates resection of a cavernous sinus meningioma through a frontotemporal approach. The operation proceeds through the middle fossa, where the fibrous tumor is entered inferiorly and internally debulked to create working space. As the mass is reduced, the dissection follows the lateral wall of the cavernous sinus, with continued attention to the trigeminal nerve branches as they are identified and preserved. Further opening of the lateral cavernous sinus wall allows additional tumor removal until cavernous sinus venous bleeding defines the limit of safe resection. Start your trial with the Neurosurgical Atlas today to gain access to our library of operative videos.

Neurosurgical Atlas

13,173 просмотров • 14 дней назад

TIMI Flow: A Key Indicator of Coronary Perfusion TIMI (Thrombolysis in Myocardial Infarction) flow grading is a crucial angiographic tool to assess blood flow in coronary arteries, particularly after an intervention like PCI. 🔹 TIMI 0 (No Flow) – Complete occlusion; no antegrade flow beyond the blockage. 🔹 TIMI 1 (Penetration without Perfusion) – Minimal flow beyond the occlusion but without adequate distal vessel opacification. 🔹 TIMI 2 (Partial Flow) – Delayed but complete filling of the distal vessel; flow is slower than normal. 🔹 TIMI 3 (Normal Flow) – Full, brisk perfusion with normal distal vessel filling, comparable to a non-diseased artery. TIMI 3 flow is the gold standard for successful reperfusion in PCI, improving outcomes in STEMI and other coronary syndromes. #Cardiology #TIMIFlow #CathLab
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TIMI Flow: A Key Indicator of Coronary Perfusion TIMI (Thrombolysis in Myocardial Infarction) flow grading is a crucial angiographic tool to assess blood flow in coronary arteries, particularly after an intervention like PCI. 🔹 TIMI 0 (No Flow) – Complete occlusion; no antegrade flow beyond the blockage. 🔹 TIMI 1 (Penetration without Perfusion) – Minimal flow beyond the occlusion but without adequate distal vessel opacification. 🔹 TIMI 2 (Partial Flow) – Delayed but complete filling of the distal vessel; flow is slower than normal. 🔹 TIMI 3 (Normal Flow) – Full, brisk perfusion with normal distal vessel filling, comparable to a non-diseased artery. TIMI 3 flow is the gold standard for successful reperfusion in PCI, improving outcomes in STEMI and other coronary syndromes. #Cardiology #TIMIFlow #CathLab

CardiovascularCorner

18,450 просмотров • 1 год назад

🟩TIMI TIMI (Thrombolysis in Myocardial Infarction) flow is an angiographic grading system used to describe the degree of epicardial coronary blood flow after reperfusion therapy (thrombolysis or PCI) in acute myocardial infarction. It was developed by the TIMI study group to provide a standardized, reproducible way to assess coronary perfusion on angiography. TIMI flow grades 🟥TIMI 0: No perfusion There is no antegrade flow beyond the point of coronary occlusion. 🟪TIMI 1: Penetration without perfusion Contrast passes beyond the obstruction but fails to opacify the entire distal coronary bed and appears to stagnate. 🟦TIMI 2: Partial perfusion Contrast crosses the obstruction and opacifies the distal bed, but flow and/or clearance is slower than in normal or non-affected coronary segments. 🟩TIMI 3: Complete perfusion Normal antegrade flow with rapid filling and clearance of contrast in the distal coronary bed, comparable to an uninvolved vessel. Key point TIMI flow reflects epicardial coronary artery patency, not microvascular perfusion. Achieving TIMI 3 flow is strongly associated with better clinical outcomes after myocardial infarction. CardiovascularCorner
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🟩TIMI TIMI (Thrombolysis in Myocardial Infarction) flow is an angiographic grading system used to describe the degree of epicardial coronary blood flow after reperfusion therapy (thrombolysis or PCI) in acute myocardial infarction. It was developed by the TIMI study group to provide a standardized, reproducible way to assess coronary perfusion on angiography. TIMI flow grades 🟥TIMI 0: No perfusion There is no antegrade flow beyond the point of coronary occlusion. 🟪TIMI 1: Penetration without perfusion Contrast passes beyond the obstruction but fails to opacify the entire distal coronary bed and appears to stagnate. 🟦TIMI 2: Partial perfusion Contrast crosses the obstruction and opacifies the distal bed, but flow and/or clearance is slower than in normal or non-affected coronary segments. 🟩TIMI 3: Complete perfusion Normal antegrade flow with rapid filling and clearance of contrast in the distal coronary bed, comparable to an uninvolved vessel. Key point TIMI flow reflects epicardial coronary artery patency, not microvascular perfusion. Achieving TIMI 3 flow is strongly associated with better clinical outcomes after myocardial infarction. CardiovascularCorner

CardiovascularCorner

11,031 просмотров • 8 месяцев назад

Temporally Traffic Disruption The Kenya National Highways Authority regrets to notify the public of the temporary closure of the the Nairobi Southern Bypass (Kikuyu Bound) between the Virtual Weighbridge and Ngong Interchange. This is due to an oil tanker that has overturned on the road, blocking traffic passage. Motorists are requested to use Waiyakiway and Uhuru Highway as the area is cleared of spillage. All road users are urged to cooperate with the police and traffic marshals on site. Corporate Communication Department
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Temporally Traffic Disruption The Kenya National Highways Authority regrets to notify the public of the temporary closure of the the Nairobi Southern Bypass (Kikuyu Bound) between the Virtual Weighbridge and Ngong Interchange. This is due to an oil tanker that has overturned on the road, blocking traffic passage. Motorists are requested to use Waiyakiway and Uhuru Highway as the area is cleared of spillage. All road users are urged to cooperate with the police and traffic marshals on site. Corporate Communication Department

Kenya National Highways Authority (KeNHA)

12,081 просмотров • 1 год назад

The importance of support. A Long 150 mm RCA #CTO with a mid-segment 12-year-old stent, tough 90-degree angle of attack proximal cap, and distal cap at the bifurcation. First attempt: radial femoral approach-no pushability antegrade or retrograde-aborted. The 2nd attempt used bi-femoral approach, the proximal cap angle of attack solved with supercross, lucky intra-stent navigation, and final tough reverse CART in a big vessel and preserved intrastent position. The radial approach is great, but sometimes, we just need more support to get the job done. The difference in support calculated by physics is huge. #CardioX #ACCFIT
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The importance of support. A Long 150 mm RCA #CTO with a mid-segment 12-year-old stent, tough 90-degree angle of attack proximal cap, and distal cap at the bifurcation. First attempt: radial femoral approach-no pushability antegrade or retrograde-aborted. The 2nd attempt used bi-femoral approach, the proximal cap angle of attack solved with supercross, lucky intra-stent navigation, and final tough reverse CART in a big vessel and preserved intrastent position. The radial approach is great, but sometimes, we just need more support to get the job done. The difference in support calculated by physics is huge. #CardioX #ACCFIT

Michael Megaly

11,338 просмотров • 1 год назад

Our very own Alexander Chen created "Hello, world" a short film inspired by the technology of his childhood with Google Labs Flow. Here's a closer look at how he brought his vision to life: 1) All of the clips were generated in Flow using text-to-image prompts except he used image-to-video prompts for the close-up shots to ensure consistency and accuracy (and the images used were generated by Imagen). 2) To evoke the exact feelings of his childhood home, he used Google Street View for visual references then asked the Google Gemini to write descriptions and prompts, then uploaded those into Flow which is what produced such vivid and accurate renderings in the film. 3) Every sound used in the video is generated by Veo 3. However, to blend things together, he used a separate video editing software to extend the head and tail of each clip over the proceeding and following clip, occasionally crossfading the audio to help with transitions.
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Our very own Alexander Chen created "Hello, world" a short film inspired by the technology of his childhood with Google Labs Flow. Here's a closer look at how he brought his vision to life: 1) All of the clips were generated in Flow using text-to-image prompts except he used image-to-video prompts for the close-up shots to ensure consistency and accuracy (and the images used were generated by Imagen). 2) To evoke the exact feelings of his childhood home, he used Google Street View for visual references then asked the Google Gemini to write descriptions and prompts, then uploaded those into Flow which is what produced such vivid and accurate renderings in the film. 3) Every sound used in the video is generated by Veo 3. However, to blend things together, he used a separate video editing software to extend the head and tail of each clip over the proceeding and following clip, occasionally crossfading the audio to help with transitions.

Google AI

94,790 просмотров • 1 год назад

🇺🇸🇮🇷 The U.S. Energy Sec. says the oil is moving through Hormuz again, and Iran can take the hint. Sec. Wright put today’s seaborne flow of oil and products at about 10M barrels a day and said that number will rise. Add the bypass pipelines and he is talking 13-15M, most of what used to leave the Gulf before the war, not all of it, but enough to call progress. Source: LiveNOW from FOX (YT) / Writer: Samuel
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🇺🇸🇮🇷 The U.S. Energy Sec. says the oil is moving through Hormuz again, and Iran can take the hint. Sec. Wright put today’s seaborne flow of oil and products at about 10M barrels a day and said that number will rise. Add the bypass pipelines and he is talking 13-15M, most of what used to leave the Gulf before the war, not all of it, but enough to call progress. Source: LiveNOW from FOX (YT) / Writer: Samuel

Mario Nawfal

61,931 просмотров • 14 дней назад

The art of patience. I could watch this over and over! Anita Pilotti working on a detail from her Alexander the Great opus vermiculatum mosaic, building it first on a temporary clay base. This is the same technique the ancient Greeks and Romans used for fine opus vermiculatum work, laying the tiny tesserae on a temporary support, then gluing the completed section, lifting it off the clay, and transferring it to its permanent cement base.
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The art of patience. I could watch this over and over! Anita Pilotti working on a detail from her Alexander the Great opus vermiculatum mosaic, building it first on a temporary clay base. This is the same technique the ancient Greeks and Romans used for fine opus vermiculatum work, laying the tiny tesserae on a temporary support, then gluing the completed section, lifting it off the clay, and transferring it to its permanent cement base.

Muse

56,729 просмотров • 2 месяцев назад

Justice Alito made it simple: TPS means TEMPORARY, not a permanent loophole to bypass normal immigration rules. Courts don’t get to override the Secretary of Homeland Security’s decisions on this. Bonus: Green light to restart metering/turnaway policies at the border, if you haven’t arrived in the U.S., you can’t claim asylum. No more abusing the system. Trump is restoring order, enforcing the law, and putting America first. This is exactly what voters demanded.
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Justice Alito made it simple: TPS means TEMPORARY, not a permanent loophole to bypass normal immigration rules. Courts don’t get to override the Secretary of Homeland Security’s decisions on this. Bonus: Green light to restart metering/turnaway policies at the border, if you haven’t arrived in the U.S., you can’t claim asylum. No more abusing the system. Trump is restoring order, enforcing the law, and putting America first. This is exactly what voters demanded.

Gunther Eagleman™

81,021 просмотров • 3 месяцев назад

🚨BREAKING: IRAN REFUSES TO BACK DOWN — HORMUZ REMAINS CLOSED Tehran has rejected reopening the Strait of Hormuz — even for a temporary ceasefire. Let that sink in. The world’s most critical energy artery… still locked. Iran is making its position clear: No temporary deals. No concessions. Only a permanent end to war. And until then— Hormuz stays shut. This is the breaking point. Because without Hormuz: Oil doesn’t flow. Supply chains don’t function. The global economy starts to seize. Diplomacy is stalling. Missiles are flying. Positions are hardening. This is no longer negotiation— This is a standoff. And standoffs don’t last forever.
4:28

🚨BREAKING: IRAN REFUSES TO BACK DOWN — HORMUZ REMAINS CLOSED Tehran has rejected reopening the Strait of Hormuz — even for a temporary ceasefire. Let that sink in. The world’s most critical energy artery… still locked. Iran is making its position clear: No temporary deals. No concessions. Only a permanent end to war. And until then— Hormuz stays shut. This is the breaking point. Because without Hormuz: Oil doesn’t flow. Supply chains don’t function. The global economy starts to seize. Diplomacy is stalling. Missiles are flying. Positions are hardening. This is no longer negotiation— This is a standoff. And standoffs don’t last forever.

Jim Ferguson

70,311 просмотров • 5 месяцев назад

A video from a SK Dhaba restaurant located on the Kalyan Bypass is rapidly going viral on social media. The video claims that a woman arrived with her friends and allegedly behaved inappropriately. According to the viral post, the restaurant staff made the woman clean up after the incident. However, the circumstances of the video, the claims, and all other details surrounding the incident have not been independently and officially confirmed. Regarding this incident, people on social media are expressing their opinions on cleanliness, responsible behavior, and civic etiquette in public places. 📍Kalyan Bypass #Mumbai #Thane #Kalyan #Maharashtra
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A video from a SK Dhaba restaurant located on the Kalyan Bypass is rapidly going viral on social media. The video claims that a woman arrived with her friends and allegedly behaved inappropriately. According to the viral post, the restaurant staff made the woman clean up after the incident. However, the circumstances of the video, the claims, and all other details surrounding the incident have not been independently and officially confirmed. Regarding this incident, people on social media are expressing their opinions on cleanliness, responsible behavior, and civic etiquette in public places. 📍Kalyan Bypass #Mumbai #Thane #Kalyan #Maharashtra

Siraj Noorani

11,839 просмотров • 3 месяцев назад

New footage from Kraków shows Tesla FSD (Supervised) tackling the "final boss" of driving: Polish roadworks. >One of the most impressive feats is how the AI correctly prioritizes temporary yellow lines over permanent white ones. Even when the original markings are confusing, faded, or overlapping, the neural network maintains the correct path. >The system instantly identifies traffic cones, bollards, and barriers. Instead of just stopping, it creates a dynamic "buffer zone" to navigate safely through narrow gaps. >The car doesn't just follow lines blindly; it observes the flow of other vehicles and responds to sudden changes in the road layout. If other car blocks the path, the system evaluates the space and decides when to bypass it based on real-time traffic behavior. Sawyer Merritt Szymon Janus TL;DR: The system is way smarter than I gave it credit for.
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New footage from Kraków shows Tesla FSD (Supervised) tackling the "final boss" of driving: Polish roadworks. >One of the most impressive feats is how the AI correctly prioritizes temporary yellow lines over permanent white ones. Even when the original markings are confusing, faded, or overlapping, the neural network maintains the correct path. >The system instantly identifies traffic cones, bollards, and barriers. Instead of just stopping, it creates a dynamic "buffer zone" to navigate safely through narrow gaps. >The car doesn't just follow lines blindly; it observes the flow of other vehicles and responds to sudden changes in the road layout. If other car blocks the path, the system evaluates the space and decides when to bypass it based on real-time traffic behavior. Sawyer Merritt Szymon Janus TL;DR: The system is way smarter than I gave it credit for.

Michał Podlewski

239,050 просмотров • 6 месяцев назад

During my recent border visit, I encountered an abandoned campsite filled with tents, food, drinks, and campfires paid for by the San Diego County taxpayers. The site is used as a temporary holding site before migrants are then processed into our country. There wasn't a person in sight, but items were scattered throughout the area.
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During my recent border visit, I encountered an abandoned campsite filled with tents, food, drinks, and campfires paid for by the San Diego County taxpayers. The site is used as a temporary holding site before migrants are then processed into our country. There wasn't a person in sight, but items were scattered throughout the area.

Supervisor Jim Desmond

193,316 просмотров • 2 лет назад