Acta neurochirurgica
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Acta neurochirurgica · Jan 2001
Aggressive surgery and focal radiation in the management of meningiomas of the skull base: preservation of function with maintenance of local control.
Recent study series have reported that post-operative external beam radiation therapy and stereotactic radiosurgery with the linear accelerator or gamma knife improves long-term local control of subtotally resected or recurrent meningiomas. ⋯ These results demonstrate that skull base meningiomas which require treatment can be managed with a combination of aggressive surgery and conformal radiation with an acceptable functional status in 99% of cases.
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Acta neurochirurgica · Jan 2001
Clinical TrialMonitoring of facial evoked EMG for hemifacial spasm: a critical analysis of its prognostic value.
Microvascular decompression (MVD) has come to stay as an effective way of treating hemifacial spasm. But it remains to be seen how much each of the electrophysiological monitoring techniques (intra-operative) are contributing to its increased efficacy. Their role as indicators for re-exploration or recurrence is to be evaluated with more studies. ⋯ Two of 21 patients who had disappearance of abnormal responses had persistent mild HFS; but in all cases, the HFS disappeared within 3 months. So we found that the intra-operative recording was really not reliable in predicting the immediate postoperative outcome. However the outcome at 3 months suggested that waiting for some time before re-exploration is a better option, especially if the HFS had become mild.
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Acta neurochirurgica · Jan 2001
Computed tomography of the brain in predicting outcome of traumatic intracranial haemorrhage in Malaysian patients.
Head injury is a significant economic, social and medical problem all over the world. Road accidents are the most frequent cause of head injury in Malaysia with highest risk in the young (15 to 24 years old). The associated outcomes include good recovery, possibility of death for the severely injured, which may cause disruption of the lives of their family members. It is important to predict the outcome as it will provide sound information to assist clinicians in Malaysia in providing prognostic information to patients and their families, to assess the effectiveness of different modes of treatment in promoting recovery and to document the significance of head injury as a public health problem. ⋯ Significant predictors of outcome were GCS on arrival in the accident emergency department, pupillary reflex and the CT scan findings. The CT predictors of outcome include ICH, EDH, IVH, present of SAH, site of ICH, volumes of EDH and SDH as well as midline shift.
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Acta neurochirurgica · Jan 2001
Case ReportsCombined surgery and endovascular stenting for basilar artery stenosis refractory to balloon angioplasty: technical case report.
The authors report a case of symptomatic basilar artery stenosis treated by stenting via the surgically exposed C1 vertebral artery. This case was initially treated by percutaneous transluminal angioplasty via a transfemoral route but resulted in unsatisfactory dilatation. Stenting via a transfemoral route also resulted in failure because of the coiling of the proximal vertebral artery. ⋯ The basilar artery was fully opened by stenting without new neurological deficits. Stenting of the basilar artery via a transfemoral route is not always possible even with newer generation stents if the vertebral artery has elongated tortuous curves. Combined surgery and endovascular stenting is one of the alternatives in such cases including our case.
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Acta neurochirurgica · Jan 2001
Case ReportsMigration of pacemaker lead into the spinal venous plexus: case report with special reference to Batson's theory of spinal metastasis.
Migration of a foreign material via venous routes into the spinal canal is a very rare incidence. We report the second case in which a foreign body has migrated into the spinal canal via the venous route. ⋯ We present a case report and review of the literature on migration of foreign material into the spinal canal, factors effecting the flow directions in the spinal veins. This case may be the first evidence that proved Batson's theory of spinal metastases in man.