Acta neurochirurgica
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Acta neurochirurgica · Oct 2007
Extra-arachnoidal cranio-cervical decompression for syringomyelia associated with Chiari I malformation in adults: technique assessment.
The osteo-dural decompression of the cerebellar tonsils at the cranio-cervical junction is generally considered the most effective treatment for syringomyelia-Chiari I complex. However much controversy concerning a great number of surgical adjuvants to the standard bony decompression is still present. In this work an extra-arachnoidal cranio-cervical decompression (CCD) without duroplasty is described and the surgical results are reported. ⋯ The extra-arachnoidal CCD is a safe and effective treatment for syringomyelia associated with Chiari I malformation in adults without intraoperative evidence of adhesive arachnoiditis. However a larger number of patients and longer follow-up will be necessary to determine the efficacy of extra-arachnoidal CCD.
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Acta neurochirurgica · Oct 2007
Leflunomide prevents vasospasm secondary to subarachnoid haemorrhage.
Though cerebral vasospasm is one of the most serious complications of subarachnoid haemorrhage (SAH), its complex pathogenesis is poorly understood and available clinical treatment options are unsatisfactory. This study was designed to examine the efficacy of leflunomide, an immunomodulatory agent with inhibitory properties, on vascular smooth muscle cell proliferation and inflammation in a rabbit cerebral vasospasm model. ⋯ This study demonstrates for the first time that leflunomide treatment attenuates cerebral vasospasm in a rabbit SAH model while inflammatory reaction in the vessel wall is not affected. Although further studies are needed to reveal its molecular mechanisms in relieving vasospasm, leflunomide may provide a therapeutic potential for human cerebral vasospasm induced by SAH.
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Acta neurochirurgica · Oct 2007
Continuous intraventricular pressure monitoring for diagnosis of normal-pressure hydrocephalus.
Normal-pressure hydrocephalus (NPH) syndrome is treatable by implantation of a cerebrospinal fluid (CSF) shunt. However, diagnosis of NPH by clinical and radiological findings alone is unreliable, and co-existing structural dementia can contribute to low success rates after shunt implantation. The aim of our study was to investigate whether long-term results after shunt implantation in NPH improve when surgical candidates are selected by continuous intraventricular pressure monitoring (CIPM). ⋯ CIPM is a safe and valuable tool to establish a reliable diagnosis of NPH and to identify promising surgical candidates.
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Acta neurochirurgica · Oct 2007
Case ReportsSpontaneous chronic head and spinal subdural haematoma.
Spinal chronic subdural haematomas (SSDH) are extremely rare. We report a case of a SSDH combined with intracranial SDH. After tapping the SSDH in addition to the evacuation of SDH, the clinical symptoms dramatically improved. SSDH are considered to have an uncertain prognosis; however, good results can be obtained with an early diagnosis and prompt treatment.
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Acta neurochirurgica · Oct 2007
Biography Historical ArticleIllustrations of neurosurgical techniques in early period of Ottoman Empire by Serefeddin Sabuncuoğlu.
Serefeddin Sabuncuoğlu (A.D. 1385-1468) was the author of the first illustrated surgery atlas Cerrahiyyetü'l Haniyye (Imperial Surgery), which was written in Turkish in 1465. The purpose of this report is to present his unique contribution to modern neurological surgery. ⋯ Serefeddin Sabuncuoğlu was a great surgeon in Turkish medical history and the sections on neurological diseases in Cerrahiyyetü'l Haniyye are of great importance in neurosurgery. Today, he is justified as a pioneer of surgery, an investigator and a medical illustrator in the early period of Ottoman Empire. His atlas is a modification of original contributions from earlier treatises.