Acta neurochirurgica
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Acta neurochirurgica · Mar 2008
Case ReportsAnterior vertebral artery decompression with an ultrasonic bone curette to treat bow hunter's syndrome.
We report a patient with bow hunter's syndrome who was treated by anterior decompression of the vertebral artery (VA) using an ultrasonic bone curette (SONOPET). This 60-year-old man reported almost losing consciousness upon head rotation. ⋯ We performed anterior decompression of the right VA at the axis using a high-speed drill and SONOPET. For anterior decompression of the VA in a deep and narrow operative field, we recommend use of SONOPET, which permits safe, easy bone dissection.
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Acta neurochirurgica · Mar 2008
ReviewVarious surgical modalities for trigeminal neuralgia: literature study of respective long-term outcomes.
The literature contains many varying, often conflicting surgical results. However, there is no study comparing long-term effectiveness of all surgical procedures for trigeminal neuralgia (TN). The aim of the present analysis is to report the long-term outcomes of surgical options of TN since the development of electronic databases, to evaluate them with the same clinical and statistical criteria and determine the most appropriate treatment. ⋯ The study suggests that each surgical technique for treatment of trigeminal neuralgia has merits and limitations. However, MVD provides the highest rate of long-term patient' satisfaction with the lowest rate of pain recurrence.
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Acta neurochirurgica · Mar 2008
Serum levels of S100B, S100A1B and S100BB are all related to outcome after severe traumatic brain injury.
S100B is an established marker of brain damage. Used in the context as a biochemical marker, S100B denotes a measurement of all S100 proteins, including at least one S100B monomer, i.e. the sum of the two dimers S100A1B and S100BB. Almost all published studies are based on this "sum concentration". However, the brain specificity of S100B has been questioned and increased serum levels have also been reported after trauma without head injury. Since the S100B monomer dominates in the brain, we hypothesised that the S100BB dimer should be better related to outcome after severe traumatic brain injury than S100A1B or the "sum concentration". ⋯ Both S100A1B and S100BB were related to outcome after severe traumatic brain injury. Even though this study is small, it seems unlikely that separate analyses of the dimers are of any advantage compared with measuring S100B alone.
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Acta neurochirurgica · Mar 2008
Risk factors for infections related to external ventricular drainage.
External ventricular drainage (EVD) is frequently used in neurosurgery for cerebrospinal fluid (CSF) drainage in patients with raised intracranial pressure. The major complication of this procedure is an EVD-related infection, i.e., meningitis or ventriculitis. The purpose of the present retrospective single centre study is to assess the possible causes of these infections. ⋯ We found a relatively high percentage of EVD-related infections. After multivariate analysis there appears to be a relation with duration of drainage and frequent CSF sampling. As a result, a new EVD protocol is proposed in our institution that we believe will decrease the number of EVD-related infections to a minimum.
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Acta neurochirurgica · Mar 2008
Hemifacial spasm: neurovascular compressive patterns and surgical significance.
The aim of this study was to report further investigation of neurovascular compression as a cause of hemifacial spasm (HFS) and to provide useful surgical guidelines by describing the compression patterns. ⋯ Once the compressing vessel responsible for the neurovascular compression are identified, the probable pattern of compression can be anticipated; this knowledge could facilitate the application of the appropriate operative procedures and minimise post-operative complications.