Acta neurochirurgica
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Alkaptonuria is a rare, autosomal recessive metabolic disorder in which the homogentisic acid oxidase activity is absent. Its incidence is as low as 0.001%. Ochronosis is the pigmentation of connective tissues and this pigmentation leads to degenerative changes in alkaptonuric patients. ⋯ This metabolic disease is often recognized on physical re-examination after the black disc material was seen during the operation. Therefore urinalysis for homogentisic acid should be performed in all patients with degenerative changes of the vertebral column. The results of disc surgery in this patient group is successful.
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Acta neurochirurgica · Aug 2006
Analysis of potential diagnostic biomarkers in cerebrospinal fluid of idiopathic normal pressure hydrocephalus by proteomics.
The pathogenesis of idiopathic normal pressure hydrocephalus (INPH) is unknown, and the syndrome of INPH remains a diagnostic and therapeutic challenge. The present study investigated the disease-specific proteins that aid in the diagnosis and treatment of INPH and thus to study their role in the disease process. ⋯ These results indicate that there are significant differences in the expression of certain proteins in the CSF of patients with INPH and normal subjects. In particular, the CSF level assay of LRG suggests that LRG is a specific biomarker for INPH and has potential use in the diagnosis and indication for CSF shunting.
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Acta neurochirurgica · Aug 2006
Case ReportsDural arteriovenous fistulas of the cavernous sinus with onset of intracerebral haemorrhage mimicking hypertensive putaminal hemorrhage.
We describe a patient with dural arteriovenous fistulas of the cavernous sinus (CS-dAVFs) who developed an intracerebral haemorrhage (ICH) mimicking hypertensive putaminal haemorrhage. Drainage into the superior ophthalmic vein (SOV) and inferior petrosal sinus (IPS) was not demonstrated on cerebral angiography, and only cortical venous reflux into the Sylvian vein was observed. In cases of venous drainage concentrated on the Sylvian vein, CS-dAVFs could indicate ICH with radiological appearance resembling putaminal haemorrhage.
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Trigeminal neuralgia is a common cause of facial pain, characterized by shock-like pain affecting one or more branches of the trigeminal nerve. When conservative treatment fails and microdecompression is not indicated, percutaneous procedures are helpful. This percutaneous approach is done by a puncture up to the Gasserian ganglion, through the foramen ovale. Although simple and safe, this puncture demands some expertise from neurosurgeons. For that, a partnership between neurosurgeons and bio-engineers has developed a model for foramen ovale puncture, allowing practice for residents and young neurosurgeons. ⋯ This model for foramen ovale puncture training has demonstrated valuable help for initial practicing of this common neurosurgical procedure, particularly in centers where there are not many cadavers available for training.
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Acta neurochirurgica · Aug 2006
Quality of life after treatment for incidental, unruptured intracranial aneurysms.
Discovering an intracranial aneurysm may profoundly affect the patient's quality of life. Patients living with unruptured and untreated aneurysms often report symptoms of anxiety and depression. There are few trials studying the quality of life after treatment of unruptured intracranial aneurysms. We aimed to compare the quality of life and symptoms of anxiety or depression after endovascular coiling or open surgery clipping of unruptured intracranial aneurysms, in patients with no prior subarachnoid haemorrhage. ⋯ Quality of life after treatment does not seem to be a strong argument for choosing one modality of treatment over the other in patients with unruptured intracranial aneurysms. There are no significant differences in the quality of life of patients successfully treated using endovascular technique and patients who underwent craniotomy and clipping. We speculate that the low quality of life scores are due to factors unrelated to the aneurysms. The scores possibly reflect characteristics of a patient group where incidental aneurysms are more frequently diagnosed while undergoing extensive imaging procedures due to unrelated symptoms.