Acta neurochirurgica
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Acta neurochirurgica · Nov 2005
The risk of rebleeding after external lumbar drainage in patients with untreated ruptured cerebral aneurysms.
Does continuous external lumbar CSF drainage before aneurysm repair in patients with aneurysmal subarachnoid hemorrhage increase the risk of rebleeding? ⋯ An increased risk of rebleeding by external lumbar drainage in the acute phase after aneurysmal SAH could not be confirmed, but the data are too imprecise to rule out an increased risk. The potential benefits of early drainage should be weighed against the risks if the aneurysm is not occluded before or early after the start of drainage.
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Acta neurochirurgica · Nov 2005
Risk factors of cerebrospinal fluid rhinorrhea following transsphenoidal surgery.
Cerebrospinal fluid (CSF) rhinorrhea is a potentially life-threatening complication following transsphenoidal surgery (TSS). ⋯ The risk of postoperative CSF rhinorrhea is significantly increased in cases with prior TSS or radiotherapy or both. In addition, these cases tended to show delayed CSF leaks and require sellar reconstruction for its treatment. When a CSF leak was encountered during TSS in these high-risk cases, thorough sellar reconstruction and long-term follow-up is necessary.
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Acta neurochirurgica · Nov 2005
Case ReportsIntensity-modulated radiosurgery for childhood arteriovenous malformations.
Presentation of intensity-modulated radiosurgery (IMRS) for the treatment of inoperable, complex shaped pediatric arterio-venous malformations AVM. ⋯ IMRS can allow for highly conformal planning and delivery of radiosurgery radiation doses even if pediatric AVM target volumes are large and/or highly complex in shape. This technique has been seen to result in favorable preliminary outcomes, thus supporting future exploration of this technique in pediatric and adult patients.
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Acta neurochirurgica · Nov 2005
Case ReportsDistal posterior inferior cerebellar artery aneurysms: clinical characteristics and surgical management.
Aneurysms located on the distal posterior inferior cerebellar artery (PICA) are rare, and their underlying clinical features and surgical management are poorly understood. We report our series of 16 patients with 18 distal PICA aneurysms. ⋯ Most of our cases of ruptured distal PICA aneurysms presented with haematocephalus. These were frequently associated with another vascular abnormality and 22% were fusiform or multilobulated. These specific features require special management strategies entailing an appropriate surgical approach to the aneurysm, clipping method, haematoma removal, ventricular drainage and when suitable choice of endovascular interventions.