Acta neurochirurgica
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Acta neurochirurgica · Dec 2009
Comparative StudyGamma knife radiosurgery for arteriovenous malformations of basal ganglia, thalamus and brainstem--a retrospective study comparing the results with that for AVMs at other intracranial locations.
The objective of this retrospective study was to study the outcome in patients with basal ganglia, thalamus and brainstem (central/deep) arteriovenous malformations (AVMs) treated with gamma knife radiosurgery (GKS) and to compare the results with that for AVMs at other intracranial locations. ⋯ GKS is an effective modality of treatment for central AVMs, though relatively lower obliteration rates and higher complication rates are seen compared to AVMs at other locations.
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Acta neurochirurgica · Dec 2009
Case ReportsOccipital inter-hemispheric approach for lateral ventricular trigone meningioma.
The optimal surgical approach for a trigone meningioma is still controversial. Here, we report two patients with trigone meningioma treated successfully via an occipital inter-hemispheric and trans-cortical approach in the lateral semi-prone position. ⋯ The occipital inter-hemispheric fissure lacks important bridging veins. The approach used and patient positioning minimized damage to the lateral aspect of the optic radiation and the corpus callosum. Except in patients with very large trigone meningiomas, this approach is useful for decreasing the risk of post-operative hemianopsia or epilepsy, and possibly speech disturbance, even in patients with a tumour in the dominant hemisphere.
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Acta neurochirurgica · Dec 2009
Case ReportsPre-mesencephalic subarachnoid hemorrhage: rupture of tiny aneurysms of the basilar artery perforator.
Subarachnoid hemorrhage (SAH) around the midbrain without evidence of aneurysm, a so-called perimesencephalic SAH, has been considered a typical nonaneurysmal SAH. Recently, we have encountered several patients with SAHs that could have been classified as having perimesencephalic SAH, but a common cause of the bleeding was demonstrated. In this article, we describe clinical and radiologic characteristics of these patients. ⋯ Based on our experience, we suggest a subtype of spontaneous SAH that has unique hemorrhage localization (pre-mesencephalic cistern), specific cause (tiny aneurysms at the origin of the mesencephalic perforator), and a common benign clinical course.
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Acta neurochirurgica · Dec 2009
Rescue microsurgery in coil herniation causing thromboembolic occlusion of parent artery.
Malpositioned coils can provoke abrupt occlusion of the parent vessels and/or neighboring branches causing stroke during coil embolization (CE) of intracranial aneurysms. The authors describe a series of cases in which urgent surgical recanalization of the vessels clogged with herniated or migrated coils rescued the patients. ⋯ This report demonstrates that timely surgical intervention could be considered as a safe and effective option to solve serious thromboembolic complications of CE associated with herniated coils.