Acta neurochirurgica
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Acta neurochirurgica · May 2012
Clinical TrialDiscovery of a new waveform for intraoperative monitoring of hemifacial spasms.
Surgeons often rely on intraoperative electrophysiological monitoring to determine whether decompression is sufficient during microvascular decompression surgery for hemifacial spasms. A new monitoring method is needed when an abnormal muscle response is occasionally not available or is unreliable. This study was an observational clinical trial exploring a new waveform recorded from the facial muscles while the offending artery wall was electrically stimulated. ⋯ We found a new waveform for intraoperative monitoring of hemifacial spasm. The Z-L response was useful when the abnormal muscle response was absent before decompression or persisted after all vascular compressions were properly treated. Particularly, the Z-L response may help neurosurgeons determine the real culprit when multiple offending vessels exist.
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Acta neurochirurgica · May 2012
Case ReportsComplications of delayed cranial repair after decompressive craniectomy in children less than 1 year old.
Decompressive craniectomy is an effective treatment option in case of refractory intracranial hypertension after severe head injury. The incidence of complications following cranial repair after decompressive craniectomy for traumatic brain injury is not negligible, particularly in infants and young toddlers. However, only a few dedicated papers can be found in the literature. ⋯ Infants less than 1 year old, undergoing decompressive craniectomy after traumatic brain injury, experience a high rate of complications following subsequent cranial repair. Subdural collections and resorption of the autologous bone flap are to be considered as extremely common complications.
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Acta neurochirurgica · May 2012
Management of bilateral trigeminal neuralgia with trigeminal radiofrequency rhizotomy: a treatment strategy for the life-long disease.
The objective of this study was to evaluate the effectiveness of percutaneous controlled radiofrequency trigeminal rhizotomy (RF-TR) in patients with bilateral trigeminal neuralgia (BTN). Patients were analyzed after RF-TR in terms of outcome, safety and complications. ⋯ RF-TR is an effective, selective, well-controlled, and effortlessly repeatable procedure for treating BTN, especially in the elderly, in terms of low morbidity and mortality rates and high rate of satisfactory pain relief.
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Acta neurochirurgica · May 2012
Outcome and prognostic features in adult pineoblastomas: analysis of cases from the SEER database.
Adult pineoblastomas (PBL) are rare central nervous system tumors. Patient and treatment factors associated with outcome are poorly defined and limited to small retrospective case series and single case reports. Using the Surveillance, Epidemiology, and End Results (SEER) cancer registry, we investigated clinicopathological factors associated with outcome in adult PBL. ⋯ Despite the numerous limitations of the SEER database, this study represents the largest analysis of adult PBL to date. Clinically relevant prognostic factors were younger age of diagnosis and localized disease. The role of surgery and adjuvant radiotherapy remains to be defined. Our data suggest these treatment modalities may not influence overall survival.
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Acta neurochirurgica · May 2012
Association of perioperative factor XIII activity levels and other haemostatic markers with the risk of postoperative intracranial haematoma in a selected cohort of neurosurgical patients.
Coagulation factor XIII and other haemostatic markers are known strengthen fibrin clot formation and, hence, may facilitate safer surgery. Currently however, factor XIII activity levels are not routinely screen. Therefore, the purpose of this study was to determine the association of perioperative factor XIII activity levels and other haemostatic markers with postoperative intracranial haematoma formation in neurosurgical patients. ⋯ Low platelet count can cause significant volume postoperative intracranial haematoma and in presence of multiple defects in haemostatic markers appears to be clinically useful to predict the formation of postoperative intracranial haematoma in neurosurgical patients.