Acta neurochirurgica
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Acta neurochirurgica · Oct 2011
Case ReportsJuvenile psammomatoid ossifying fibroma of the orbit and paranasal sinuses. A case report.
Juvenile psammomatoid ossifying fibroma (JPOF) is an uncommon benign fibro-osseous lesion predominantly arising in the paranasal sinuses and orbits of children and young adults. We report a case of JPOF involving the paranasal sinuses and orbit in a 15-year-old boy that presented due to progressive proptosis and downward displacement of the left eye. The lesion, first described as fibrous dysplasia (FD), was totally removed surgically, and then proved to be a JPOF, by histopathology. We discuss its differential diagnosis with other fibro-osseous lesions, histopathological features, and treatment options.
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Acta neurochirurgica · Oct 2011
ReviewThe fully endoscopic supraorbital trans-eyebrow keyhole approach to the anterior and middle skull base.
The purely endoscopic eyebrow supraorbital approach is an alternative to both the endoscopic endonasal and eyebrow microsurgical routes to the anterior and middle cranial base. It combines an enhanced visualization provided by the endoscope and the absence of cerebrospinal fluid (CSF) leaks and nasal complications. ⋯ The purely endoscopic eyebrow supraorbital keyhole approach is a valuable and alternative minimally invasive route to anterior and middle skull base lesions.
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Acta neurochirurgica · Oct 2011
Case ReportsOccipital WHO grade II gliomas: oncological, surgical and functional considerations.
Diffuse WHO grade II glioma (GIIG) involving the occipital lobe is a rare entity. Its surgical resection remains controversial as it implies inducing a permanent visual deficit. For the first time to our knowledge, we report a consecutive surgical series of patients who underwent an occipital lobectomy for an LGG invading visual structures. ⋯ Our findings suggest that, despite a definitive hemianopsia, an extensive surgical resection can be considered in the rare cases of occipital GIIG involving the primary visual structures, with patients able to maintain a normal life--except regarding the medico-legal problem of driving.
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Acta neurochirurgica · Oct 2011
Case ReportsEndoscopic third ventriculostomy for hydrocephalus after perimesencephalic subarachnoid hemorrhage: initial experience in three patients.
To review the outcome after endoscopic third ventriculostomy (ETV) for symptomatic, persistent hydrocephalus in three patients with perimesencephalic angiographically negative subarachnoid hemorrhage (PNH) who were dependent on an external ventricular drain (EVD). ⋯ To our knowledge, this is the first report of ETV for PNH with hydrocephalus and the first report of a basilar tip microaneurysm seen intraoperatively during ETV. ETV is a viable treatment option for refractory hydrocephalus secondary to a perimesencephalic pattern of subarachnoid hemorrhage (SAH). Its early application can avoid placement of a ventriculoperitoneal shunt, curtail the extended use of an EVD, and reduce the associated infection risks. Despite thorough angiographic investigation for an aneurysmal cause of SAH, a "microaneurysm" of the basilar artery was found at ETV. No complication or rebleeding was encountered.
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Acta neurochirurgica · Oct 2011
Case ReportsNerve transfers using collateral branches of the brachial plexus as donors in patients with upper palsy--thirty years' experience.
Nerve transfers in cases of directly irreparable or high-level extensive brachial plexus traction injuries have been done using a variety of donor nerves with various success, but an ideal method has not been established. The purpose of this study is to analyze the results of nerve transfers using the thoracodorsal and medial pectoral nerves as donors in patients with upper palsy. ⋯ According to our findings, nerve transfers using collateral branches of the brachial plexus in cases with upper palsy offer several advantages and yield high rate and good quality of recovery.