Acta neurochirurgica
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Acta neurochirurgica · Jul 2008
Administration off label of recombinant factor-VIIa (rFVIIa) to patients with blunt or penetrating brain injury without coagulopathy.
Traumatic brain contusions may increase in size over time or may develop at a delay after injury. This may lead to neurological deterioration, long term morbidity or even death. Coagulation disorders after injury can contribute to progression of haemorrhage. ⋯ Although the majority of patients were considered to be at high risk of progression of their lesions, this occurred in only one. The early use of rFVIIa in head injured patients without systemic coagulopathy may reduce the occurrence of enlargement of contusions, the requirement of further operation, and adverse outcome. Prospective randomised controlled studies are required to investigate this.
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Acta neurochirurgica · Jul 2008
Case ReportsEndovascular coil transfixing a cranial nerve five years after embolisation.
After endovascular coiling, several authors have reported refilling of the aneurysm, appearance of a mass effect, coils protruding into the parent artery, migration of coils into parent artery or through aneurysm wall, and compression of the parent artery by coil impaction. This is the first report of an endovascular coil transfixing a cranial nerve. We present a 59 year old man who presented with a symptomatic bilobulated aneurysm of the right internal carotid artery. ⋯ Follow-up angiography showed renewed filling of the aneurysm at its neck. The aneurysm was clipped surgically. At operation, a coil mass effect was noted and one coil penetrated the fibres of the right oculomotor nerve.
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Acta neurochirurgica · Jul 2008
Evaluation of retrosigmoid vestibular neurectomy for intractable vertigo in Ménière's disease: an interdisciplinary review.
Retrosigmoid vestibular neurectomy is suggested to be the most effective and safe procedure to control intractable vertigo associated with Ménière's disease. The purpose of this study is to report the excellent efficacy of vertigo control, the good preservation of hearing, the rare complications and the simplicity of retrosigmoid vestibular neurectomy performed by an interdisciplinary team of neurosurgery and otorhinolaryngology experts of our teaching hospital. ⋯ Selective vestibular neurectomy via the retrosigmoid approach is an effective and simple neurosurgical procedure for the control of intractable vertigo in Ménière's disease while preserving hearing.