Acta neurochirurgica
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Acta neurochirurgica · Sep 2010
A modified Roland-Morris disability scale for the assessment of sciatica.
The Roland-Morris disability scale (RMS) for disability secondary to low back pain is a validated and popular instrument in clinical practice and research. We have made a simple modification to the questionnaire to increase sensitivity to sciatica (RMS-L) and validated this in patients with lumbar disc prolapse and radiculopathy. ⋯ The original and modified RMS can discriminate disability due to low back pain and sciatica, respectively. Separate assessment of these symptoms and their contribution to functional impairment is useful in assessing suitability for surgery and predicting outcome.
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Acta neurochirurgica · Sep 2010
Case ReportsAdenocarcinoma of the prostate involving the lumbosacral plexus: MRI evidence to support direct perineural spread.
Prostate adenocarcinoma, which may recur despite aggressive treatment, has the potential to spread to the lumbosacral plexus. This intraneural involvement is not widely known and is thought to be from direct perineural spread. We hypothesized that high-resolution imaging could provide supportive evidence for this mechanism. ⋯ The potential for prostate adenocarcinoma to spread to the lumbosacral plexus has, to our knowledge, not been readily appreciated. Because the imaging findings are often subtle, we believe that intraneural lumbosacral plexus involvement may not be uncommon. This study, with the use of high-resolution MRI and PET/CT studies, supports the direct perineural spread of prostate adenocarcinoma via the pelvic plexus to the lumbosacral plexus. This mechanism could also explain cases of leptomeningeal and/or dural-based prostate metastases.
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Acta neurochirurgica · Sep 2010
Case ReportsThe 'triangle' rubber dam interposition technique: preservation of the arteries around an aneurysm.
The authors describe an intraoperative technique in which a triangular rubber dam is inserted between the aneurysm and the perforating arteries. In this way, we can avoid obstruction of perforating arteries on application of a clip. This technique is especially useful for deep-seated aneurysms, such as basilar bifurcation aneurysms.
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Acta neurochirurgica · Sep 2010
Procedural predictors of delayed cerebral infarction after intra-arterial vasodilator infusion for vasospasm following aneurysmal subarachnoid hemorrhage.
The goals of this study were to identify predictors of delayed cerebral infarction in aneurysmal SAH after intra-arterial (IA) vasodilator infusion and to select proper parameters for treatment success. ⋯ Angiographic CCT and residual narrowing at the end of IA vasodilator infusion were found to predict the subsequent occurrence of cerebral infarction. The authors suggest that residual narrowing of 30% and a CCT of 7 s could be used as a minimum indicator of IA vasodilator infusion endpoints.
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Acta neurochirurgica · Sep 2010
Comparative StudyThe sutureless excimer laser assisted non-occlusive anastomosis (SELANA); a feasibility study in a pressurized cadaver model.
To compare intracranial feasibility of the conventional Excimer laser assisted non-occlusive anastomosis (ELANA) with the new experimental sutureless ELANA (SELANA). ⋯ This comparative study shows potential advantages of the SELANA anastomosis over the ELANA anastomosis because during application, it causes less manipulation of surrounding structures while it is faster and easier. Further preclinical research should be performed in order to improve SELANA feasibility on angulated anastomosis spots and to assess long-term SELANA patency and endothelialization.