Acta neurochirurgica
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Acta neurochirurgica · Apr 2006
Clinical TrialEfficacy of bilateral subthalamic nucleus (STN) stimulation in Parkinson's disease.
Deep brain stimulation (DBS) has, for the most part, replaced irreversible stereotactic coagulations in the surgical treatment of advanced Parkinson's disease. This study was undertaken to evaluate the benefits of bilateral STN stimulation related to its potential risks and side effects. ⋯ The majority of Parkinsonian patients experienced significant and long lasting relief from their motor symptoms and an improvement in ADL functions due to DBS-STN therapy when evaluated at the best on-medication phase.
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Acta neurochirurgica · Apr 2006
The Camino intracranial pressure device in clinical practice. Assessment in a 1000 cases.
Intracranial pressure (ICP) monitoring has become standard in the management of neurocritical patients. A variety of monitoring techniques and devices are available, each offering advantages and disadvantages. Analysis of large populations has never been performed. ⋯ The Camino ICP sensor remains one of the most popular ICP monitoring devices for use in critical neurosurgical patients. The system offers reliable ICP measurements in an acceptable percentage of device complications and the advantage of in vivo recalibration. The incidence of technical complications was low and similar to others devices.
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Acta neurochirurgica · Apr 2006
High jugular bulb in the translabyrinthine approach to the cerebellopontine angle: anatomical considerations and surgical management.
Evidence of a high jugular bulb position (HJBP) during the translabyrinthine approach may compromise the surgical removal of cerebellopontine angle (CPA) tumours. We report a simple surgical procedure to safely manage this frequent normal variation and comment on various alternative options. ⋯ The HJBP can be systematically diagnosed with the preoperative CT-scan using bone window imaging. Our results demonstrate that the described procedure is safe and effective to widen the operative corridor that is required for the exposure of the inferior compartment of the CPA in this anatomical situation.
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Acta neurochirurgica · Apr 2006
Case ReportsCombined use of a radial fore arm free flap for extra-intracranial bypass and for antero-lateral skull base reconstruction--a new technique and review of literature.
This article describes a new surgical technique consisting of the combined use of a fascial radial fore arm free flap (RFFF) as vascular graft for extra-intracranial bypass and as dura mater plasty for reconstruction of the antero-lateral skull base. This new technique is illustrated by a case of a complex intracranial meningioma with extracranial extension necessitating resection of internal carotid artery. The technical issues of antero-lateral skull base reconstruction and extra-intracranial bypass are discussed and the literature is reviewed.