Acta neurochirurgica
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Acta neurochirurgica · Jan 1994
Review Case ReportsIntraosseous calvarial meningioma of the skull presenting as a solitary osteolytic skull lesion: case report and review of the literature.
Intraosseous calvarial meningiomas, defined as meningiomas confined to the skull with no epidural or subcutaneous component, are rare and usually exhibit osteoblastic activity. We present a case of a primary intraosseous meningioma in the right frontal bone that presented radiologically as a solitary lytic skull lesion and was completely excised. ⋯ According to our review of the literature, our case is the first with documentation on computed tomography. In cases of solitary osteolytic skull lesions, meningioma should be considered even though it may not seem likely, because management will be directed to radical excision with good prognosis rather than biopsy.
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Acta neurochirurgica · Jan 1994
Case ReportsArteriovenous malformations that rupture during pregnancy: a management dilemma.
Intracranial haemorrhage due to rupture of an arteriovenous malformation (AVM) during pregnancy is a rare but serious condition that warrants prompt recognition. Once the diagnosis is made, the management is primarily based on neurosurgical rather than obstetric considerations. ⋯ These cases well summarize the difficulties encountered in treating such patients. The diagnostic as well as the therapeutic implications of this condition are discussed.
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Acta neurochirurgica · Jan 1994
Statistical analysis of the factors affecting the outcome of extradural haematomas: 115 cases.
115 traumatic extradural haematoma cases who were treated surgically at Cerrahpasa Medical Faculty Neurosurgery Department between 1987 and 1992 are evaluated. When factors affecting the outcome were examined, a strong correlation was found between the result and Glasgow coma scale (GCS) (p < 0.00001). The existence of a fracture, the interval between onset of haematoma symptoms and intervention and the existence of an intracerebral haematoma together with contusion accompanying intradural haematoma, affect the outcome in a negative direction. There was no statistical correlation between the outcome and the age of patient, localization of the haematoma and aetiology.
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Acta neurochirurgica · Jan 1994
Facial motor responses evoked by direct electrical stimulation of the trigeminal root. Localizing value for radiofrequency thermorhizotomy.
In Sweet's description of RF-thermocoagulation for trigeminal neuralgia, the trigeminal nerve was stimulated at 50 c/s to evoke paraesthesias, in order to check the electrode location before the thermolesion is made. In 1979, we changed the frequency to 5 c/s, so as to produce in addition twitches in the masticatory muscles (in stead of the less detectable tetanization produced by 50 c/s stimulation). Since then, we started to observe, also, twitches in the muscles innervated by the facial nerve. ⋯ So, getting EMR in the territory of the pain can be a helpful indicator for an accurate location of the electrode in the trigeminal root, according to its somatotopic organization. These EMR are hypothesized to be due to a trigemino-facial reflex. A preliminary intra-operative EMG study clearly shows that for EMR in the upper part of the face we are dealing with blink-like reflexes, whilst for EMR in the lower face, mechanisms still remain unclear and need further study to be understood.