Acta neurochirurgica
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Pituitary surgery is a recent development in neurosurgery and most of the surgical techniques concerned have been described within the last century. We provide a historical perspective by reviewing the major steps in the development of this neurosurgical subspecialty through the ages. We concentrate on the most important figures whose advances in the study of the physiology and anatomy of the pituitary are most significant. This journey into the past will demonstrate that our current knowledge is the summation of a long road of investigation.
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Acta neurochirurgica · Nov 2011
Case ReportsCarotid artery stenting in a patient with right-sided aortic arch with an aberrant left subclavian artery.
A right-sided aortic arch with an aberrant left subclavian artery is a rare anatomical variation. We report a case treated with carotid artery stenting (CAS) for a patient with a right-sided aortic arch with an aberrant left subclavian artery. A 72-year-old man presented right hemiparesis due to acute brain infarction. ⋯ CAS was performed with a proximal balloon and distal filter protection. The stenotic area was restored, and the patient was discharged without suffering recurrent attacks. Although a right-sided aortic arch with an aberrant left subclavian artery is a very rare anatomical variation, it can be encountered in neuroendovascular treatment, and therefore knowledge of this anatomical variation is important.
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Acta neurochirurgica · Nov 2011
Comparative StudyThe use of nicardipine prolonged release implants (NPRI) in microsurgical clipping after aneurysmal subarachnoid haemorrhage: comparison with endovascular treatment.
Nicardipine prolonged release implants (NPRI) have been shown to decrease the incidence of cerebral vasospasm and infarcts significantly in patients after aneurysmal subarachnoid haemorrhage (SAH) following microsurgical clipping. Yet, the comparison with results after endovascular coiling is lacking. This study was conducted to determine the differences in the incidence of cerebral vasospasm and infarctions between those two treatment modalities ⋯ The use of NPRI during microsurgical clipping was confirmed to be safe and effective. Patients who received intracisternally implanted NPRI during clipping after aneurysmal SAH yielded significantly lower vasospasm and infarction rates, and showed a better clinical outcome when compared with clipping without NPRI and also when compared with endovascular coiling.