Acta neurochirurgica
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Acta neurochirurgica · Dec 2002
Epidemiological, forensic, clinical, and imaging characteristics of head injuries acquired in the suicide attempt with captive bolt gun.
The captive bolt gun (slaughterer's gun) is a tool used in the meat industry for "humane killing" of animals. Used with the intent of suicide, the captive bolt gun causes very serious injuries. We analysed 19 self-inflicted head injuries with captive bolt gun during the past 20 years. ⋯ The clinical appearance of the entrance wound and the imaging characteristics of the cranial trauma are very specific, and can be easily differentiated from firearm or other penetrating injuries. These wounds were always primarily infected with mixed bacterial flora from the skin. Therefore, besides radical primary wound care, especially of the wound canal with removal of foreign bodies, it is important to administer high doses of wide spectrum antibiotics.
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Acta neurochirurgica · Dec 2002
Case ReportsImpact of brain shift on intraoperative neurophysiological monitoring with cortical strip electrodes.
Intraoperative neurophysiological monitoring has become the standard procedure for locating eloquent regions of the brain. Such continuous electrical stimulation of motor pathways is usually applied by means of flat silicon-embedded electrodes placed directly on the motor cortex. However, shifting of the silicon strip on the cortical surface as well as electrode displacement due to brain shift underneath the electrode can lead to inaccurate recordings not directly caused by intraoperative impairment of the motor cortex or the motor pathways. ⋯ Changes in the location of cerebral structures due to intraoperative brain shift may exert a marked influence on intraoperative neurophysiological monitoring if cortical strip electrodes are used. Therefore, long-term monitoring of the central region requires continuous checking of the position of stimulating electrodes and, if necessary, correction of their location.
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Acta neurochirurgica · Dec 2002
The microsurgical anatomy of the cisternal segment of the trochlear nerve, as seen through different neurosurgical operative windows.
To describe the anatomy of the cisternal segment of the trochlear nerve as seen through different neurosurgical approaches. ⋯ The trochlear nerve is a very delicate structure that can be easily injured during approaches to the tentorial incisura. Accurate knowledge of its anatomy as seen through different operative windows is helpful in maintaining its integrity during surgery.