Acta neurochirurgica
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Acta neurochirurgica · Jun 2011
Comparative StudyManagement, risk factors and outcome of cranial dural arteriovenous fistulae: a single-center experience.
The role of endovascular interventions in managing dural arteriovenous fistulas (DAVFs) is increasing. Furthermore, in patients with aggressive DAVFs, different surgical interventions are required for complete obliteration or disconnection. Our objective was to evaluate the management of patients with intracranial DAVFs treated in our institution to identify the parameters that may help guide the long-term management of these lesions. ⋯ In general, intracranial DAVFs can be successfully surgically managed by simple venous disconnection in many cases. However, half of the patients do not show complete remission of symptoms. Age and the occurrence of perioperative complication were the most important determinants of outcome.
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Acta neurochirurgica · Jun 2011
Delayed caroticocavernous fistula after stent-assisted coil embolization of intracavernous carotid aneurysm: should we manage conservatively?
Constructive endovascular techniques remain the mainstay for the treatment of cavernous carotid aneurysms due to their efficacy. However, they do harbor risks of complications, such as thromboembolic events, arterial injuries, and vessel occlusions. ⋯ Our case demonstrates a unique presentation of a CCF as a delayed complication of stent-assisted coil embolization of CCA and the spontaneous resolution of the CCF. Symptomatic CCFs are commonly treated as an emergency in many institutions and the question arises as to whether we should adopt a conservative policy in the light of this case report.
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Among the potential approaches to access the petroclival area, epidural anterior petrosectomy (EAP) appears to be the most direct and conservative transpetrous route. In this article, we aim to detail the relevant surgical steps necessary to perform EAP in a reproducible and safe manner. ⋯ Epidural anterior petrosectomy is a conservative trans-petrous approach that offers an excellent direct surgical corridor for exposure of disease processes involving Meckel's cave, the petroclival area and the ventrolateral pons.
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Acta neurochirurgica · Jun 2011
Feasibility of intraoperative motor-evoked potential monitoring for skull base tumors with a high risk of postoperative motor deterioration.
To establish the validity and utility of motor-evoked potential (MEPs) monitoring for skull base tumor resection, we explored the relationship between MEP monitoring results and postoperative motor function. ⋯ Intraoperative MEP monitoring is a valid indicator of pyramidal tract pathway function for skull base tumor surgery.
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Acta neurochirurgica · Jun 2011
Case ReportsDevelopment of intratumoral cyst or extratumoral arachnoid cyst in intracranial schwannomas following gamma knife radiosurgery.
Intracranial schwannomas presenting with cyst formation following gamma knife radiosurgery (GKRS) were investigated to clarify their clinicopathological characteristics. ⋯ There were two types of cysts, intratumoral cyst and extratumoral arachnoid cyst, which developed following GKRS in intracranial schwannomas. Resection of the solid compartment as well as the cyst is required in schwannomas with expanding intratumoral cyst. Conversely, fenestration of the cyst alone might be effective in extratumoral arachnoid cysts.