Acta neurochirurgica
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Acta neurochirurgica · Mar 2013
Comparative StudyHow I do it--pineal surgery: supracerebellar infratentorial versus occipital transtentorial.
Resection of a pineal tumour requires fastidious pre-operative planning to select the optimal surgical approach and maximise resection while minimising morbidity. ⋯ Specific considerations include patient-specific anatomy, extent and relationships of the tumour, and the techniques likely to be employed during resection. The supracerebellar infratentorial approach provides a direct corridor to pineal tumours caudal to the deep veins; for tumours invaginating the tectal plate in a caudal direction the occipital transtentorial provides a better view.
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Acta neurochirurgica · Mar 2013
Application of low-field intraoperative magnetic resonance imaging in transsphenoidal surgery for pituitary adenomas: technical points to improve the visibility of the tumor resection margin.
Intraoperative magnetic resonance imaging (iMRI) is proven to be advantageous in transsphenoidal surgery (TSS) for pituitary adenomas. We evaluated the efficacy of low-field iMRI. Also, we described several techniques to enhance the visibility of the tumor resection margin. ⋯ iMRI maximizes the extent of resection and minimizes the possibility of unexpected tumor remnants in TSS for pituitary adenomas. It is essential to reduce imaging artifacts and enhance the visibility of the tumor resection margin during the use of low-field iMRI.
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Acta neurochirurgica · Mar 2013
ReviewHypertrophic olivary degeneration following surgical resection or gamma knife radiosurgery of brainstem cavernous malformations: an 11-case series and a review of literature.
We describe 11 patients with hypertrophic olivary degeneration (HOD) after surgical resection or gamma knife radiosurgery for brainstem cavernous malformations. In addition, we statistically analyzed the predicting factors associated with the development of HOD. ⋯ HOD should be recognized as a non-infrequent complication of surgical resection or gamma knife radiosurgery within the brainstem, especially for midbrain cavernous malformations. In addition, to the best of our knowledge, this is the first report on HOD development after radiosurgery.
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Acta neurochirurgica · Mar 2013
Comparative StudyApplicability of nTMS in locating the motor cortical representation areas in patients with epilepsy.
Transcranial magnetic stimulation (TMS) is increasingly used for non-invasive functional mapping in preoperative evaluation for brain surgery, and the reliability of navigated TMS (nTMS) motor representation maps has been studied in the healthy population and in brain tumor patients. The lesions behind intractable epilepsy differ from typical brain tumors, ranging from developmental cortical malformations to injuries early in development, and may influence the functional organization of the cortical areas. Moreover, the interictal cortical epileptic activity and antiepileptic medication may affect the nTMS motor threshold. The reliability of the nTMS motor representation localization in epilepsy patients has not been addressed. ⋯ nTMS can reliably locate the hand motor cortical representation area with the accuracy needed for pre-surgical evaluation in patients with epilepsy.
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Acta neurochirurgica · Mar 2013
Indocyanine green videoangiography (ICGV)-guided surgery of parasagittal meningiomas occluding the superior sagittal sinus (SSS).
Maximal safe resection is the goal of correct surgical treatment of parasagittal meningiomas, and it is intimately related to the venous anatomy both near and directly involved by the tumor. Indocyanine green videoangiography (ICGV) has already been advocated as an intra-operative resourceful technique in brain tumor surgery for the identification of vessels. The aim of this study was to investigate the role of ICGV in surgery of parasagittal meningiomas occluding the superior sagittal sinus (SSS). ⋯ Despite the small number of patients, our study shows that ICG videoangiography could play a crucial role in guiding surgery of parasagittal meningioma occluding the SSS. Further studies are needed to define the role of this technique on functional and oncological outcome of these patients.