Acta neurochirurgica
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Acta neurochirurgica · Mar 2011
Midline-craniotomy of the posterior fossa with attached bone flap: experiences in paediatric and adult patients.
Osteoplastic craniotomy in midline approaches to the posterior fossa has been proposed as an alternative to traditional osteoclastic craniectomy. Data from paediatric patients suggest that this method has advantages in terms of perioperative complications. The authors investigate midline craniotomy of the posterior fossa with a modified technique in paediatric, as well as in adult patients. ⋯ Midline craniotomy of the posterior fossa is feasible in adult patients, as well as in children. The technique does not seem to be associated with additional risks. Larger comparative series will be needed in order to evaluate possible advantages of the technique over osteoclastic craniectomy.
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Acta neurochirurgica · Mar 2011
Comparative StudyMinimally invasive percutaneous transpedicular screw fixation: increased accuracy and reduced radiation exposure by means of a novel electromagnetic navigation system.
Minimally invasive percutaneous pedicle screw instrumentation methods may increase the need for intraoperative fluoroscopy, resulting in excessive radiation exposure for the patient, surgeon, and support staff. Electromagnetic field (EMF)-based navigation may aid more accurate placement of percutaneous pedicle screws while reducing fluoroscopic exposure. We compared the accuracy, time of insertion, and radiation exposure of EMF with traditional fluoroscopic percutaneous pedicle screw placement. ⋯ Minimally invasive pedicle screw placement with the aid of EMF image guidance reduces fluoroscopy time and increases placement accuracy when compared with traditional fluoroscopic guidance while adding no additional time to the procedure.
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Acta neurochirurgica · Mar 2011
General anaesthesia for deep brain stimulator electrode insertion in Parkinson's disease.
This paper compares the use of general and local anaesthetic in patients having deep brain stimulator (DBS) surgery. It is a retrospective case note study of 46 patients treated consecutively with subthalamic nucleus stimulation for Parkinson's disease as practise changed in a Neurosurgical unit. ⋯ This study describes benefits in the GA group for the entire procedure of STN DBS. In these samples, there was no difference in the adverse effects seen in patients undergoing deep brain stimulator insertion with general anaesthetic compared with local anaesthetic. The use of general anaesthetic did not detract from the known benefits of surgery.
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Acta neurochirurgica · Mar 2011
ReviewDeep brain stimulation therapy for treatment-refractory Tourette's syndrome: A review.
Tourette's syndrome is a chronic neurobehavioral disorder that can demonstrate refractoriness to conservative treatments, or to invasive nonsurgical treatments such as botulinum toxin infiltration, or to psychobehavioral treatments. In these cases, the surgical option is often proposed, either with lesional interventions, or more recently with deep brain stimulation (DBS). This latter modality is currently preferred because of its reversibility and modularity. Some relevant issues, however, still persist in terms of appropriate indication to treatment, selection of target, and follow-up evaluation.
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Acta neurochirurgica · Mar 2011
Comparative StudyReduction in external ventricular drain infection rate. Impact of a minimal handling protocol and antibiotic-impregnated catheters.
Many strategies have been developed with the aim of reducing external ventricular drain-related infections. Antibiotic-impregnated catheters are one of them. ⋯ Minimal handling protocols constitute an essential strategy in the reduction of external ventricular drain-related infections. Besides that, the use of antibiotic-impregnated catheters may reduce infection-related hospital costs.