Acta neurochirurgica
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Acta neurochirurgica · Nov 2007
Randomized Controlled TrialErythropoietin in patients with aneurysmal subarachnoid haemorrhage: a double blind randomised clinical trial.
Erythropoietin (EPO) is neuroprotective in experimental models of stroke and subarachnoid haemorrhage (SAH) and possibly in patients with thromboembolic stroke. We studied the efficacy and safety of EPO in patients with SAH. ⋯ Beneficial effects of EPO in patients with SAH cannot be excluded or concluded on the basis of this study and larger scale trials are warranted.
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Acta neurochirurgica · Nov 2007
Diffusion tensor imaging and white matter tractography in patients with brainstem lesions.
Diffusion tensor imaging (DTI) and white matter tractography (WMT) are promising techniques for estimating the course, extent, and connectivity patterns of the white matter (WM) structures in the human brain. In this study, we investigated the ability of DTI and WMT to visualize white matter tract involvement for the preoperative surgical planning and postoperative assessment of brainstem lesions. ⋯ Compared with the information provided by conventional MR imaging, DTI and WMT provided superior quantification and visualization of lesion involvement in eloquent fibre tracts of the brainstem. Moreover, DTI and WMT were found to be beneficial for white matter recognition in the neurosurgical planning and postoperative assessment of brainstem lesions.
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Acta neurochirurgica · Nov 2007
Primary CNS lymphoma treated with combined intra-arterial ACNU and radiotherapy.
To assess whether nimustine (ACNU), a drug that can cross the blood brain barrier, combined with radiotherapy, improved the survival of patients with primary central nervous system lymphoma (PCNSL). ⋯ The intra-arterial administration of ACNU combined with radiation therapy yielded a high response rate at acceptable toxicity levels in younger patients with PCNSL. However, late neurotoxicity was a serious complication in patients above 60 years of age.
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Acta neurochirurgica · Nov 2007
Case ReportsNeuronavigation guided surgery for parenchymal neurocysticercosis in two patients.
Neurocysticercosis is a rare disease in the Baltic area while it is common in the endemic regions. Two patients with serologically negative parenchymal neurocysticercosis from our neurosurgical department who underwent extirpation of the cystic lesions with neuronavigation guided surgery are reported in this paper. Though most publications propose medical treatment with albendazole and praziquantel for parenchymal neurocysticercosis, surgery can be an option for diagnosis and treatment in conjunction with cysticidal medication if the diagnosis is unclear particularly in non-endemic areas.
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Acta neurochirurgica · Nov 2007
Surgical disconnection of cortical venous reflux as a treatment for Borden type II dural arteriovenous fistulae.
The presence of cortical venous reflux is recognized as an indicator of increased risk of intracranial hemorrhage and neurological deficits in cranial dural arteriovenous fistulas. Its disconnection is well accepted as a treatment for fistulas with direct cortical reflux (Borden type III), but the role of disconnection of the cortical venous reflux in the management of fistulas that involve the venous sinus and cortical venous reflux (Borden type II) is still a matter of debate. We analyze the experience of the Toronto Brain Vascular Malformation Study Group in the management of these lesions by simple cortical venous reflux disconnection and its impact in the future risk of bleeding. ⋯ Simple surgical disconnection of the cortical venous reflux maybe an option in the management of patients with Borden type II dural arteriovenous fistulas. This procedure is a much smaller surgical undertaking and is associated with fewer complications than attempts to resect or pack the whole fistula, especially if located in the skull base.