Acta neurochirurgica
-
Awake craniotomy is a valuable procedure since it allows brain mapping and live monitoring of eloquent brain functions. The advantage of minimizing resource utilization is also emphasized by some physicians in North America. Data on how well an awake craniotomy is tolerated by patients and how much stress it creates is available from different studies, but this topic has not consequently been summarized in a review of the available literature. Therefore, it is the purpose of this review to shed more light on the still controversially discussed aspect of an awake craniotomy. ⋯ For selected patients, an awake craniotomy presents the best possible way to reduce the risk of surgery related neurological deficits. However, benefits and burdens of this type of procedure should be carefully considered when planning an awake craniotomy and the decision should serve the interests of the patient.
-
Acta neurochirurgica · Jun 2014
The strategy of microvascular decompression for hemifacial spasm: how to decide the endpoint of an MVD surgery.
Microvascular decompression (MVD) has become the standard treatment for hemifacial spasm. As not all patients get complete relief, this strategy is still controversial. The study aimed to figure out how to tell the proper endpoint to the surgery. ⋯ MVD operations can be ended only after the full-length evidence, vascular evidence and electrophysiological evidence are all present.
-
Acta neurochirurgica · Jun 2014
Microvascular decompression in patients with coexistent trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia.
Trigeminal neuralgia(TN), hemifacial spasm (HFS) and glossopharyngeal neuralgia (GPN) were referred to hyperactive dysfunction syndromes (HDSs) of the cranial nerves. These symptoms may occur synchronously or metachronously, but the combination of three diseases is extremely rare. ⋯ The combination of HFS-TN-GPN is extremely rare and is often associated with a looped VBA and a smaller posterior fossa. However, MVD is still a good choice for treatment. To achieve a safe and effective outcome, dissection of the caudal cranial nerves and proximal transposition of the vertebral artery before decompression of the affected nerve roots are strongly recommended.
-
Acta neurochirurgica · Jun 2014
Selection of surgical approaches based on semi-quantifying the skull-base invasion by petroclival meningiomas: a review of 66 cases.
Petroclival meningiomas are still challenging for neurosurgeons. In the present study, we reviewed 66 petroclival meningiomas that underwent craniotomy to assess the surgical approaches for petroclival meningiomas based on semi-quantifying tumor extension to skull base and to evaluate the outcomes. ⋯ We introduced a simple and practicable method for classification of petroclival meningiomas, which could semi-quantify tumor invasion and help to select surgical approaches. With careful preoperative evaluation, a cautiously selected approach would improve the prognosis.
-
Acta neurochirurgica · Jun 2014
A retrospective study of 113 consecutive cases of surgically treated spondylodiscitis patients. A single-center experience.
Recommendations for the operative treatment of spondylodiscitis are still a controversial issue. ⋯ The results of our retrospective study show that surgical treatment of spondylodiscitis with a staged surgical approach (if needed) and a short 1-2-week period of intravenous antibiotics followed by 3 months of oral antibiotics is appropriate for most patients in whom conservative treatment has failed or is not advisable. Furthermore, surgical treatment of newly diagnosed spondylodiscitis might be recommended as an initial treatment option in many cases. Thereby the choice of fusion material (autologous bone, titanium, PEEK) seems less important.