Acta neurochirurgica
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Acta neurochirurgica · Oct 2009
Case ReportsImaging-documented repeated intratumoral hemorrhage in vestibular schwannoma: a case report.
Intratumoral hemorrhage in vestibular schwannomas is rare. Symptoms often have an acute onset and include headache, nausea, vomiting, vertigo, and depressed consciousness. ⋯ The present report details the case of acute neurological deterioration in a patient with repeated intratumoral hemorrhage inside a vestibular schwannoma with computed tomography and magnetic resonance imaging confirmation. To our knowledge, repeated hemorrhage in vestibular schwannoma with radiological confirmation has not been reported before.
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Acta neurochirurgica · Oct 2009
Case ReportsAnterior screw fixation of a dislocated type II odontoid fracture facilitated by transoral and posterior cervical manual reduction.
Early fixation of type II odontoid fractures has been shown to provide high rates of long-term stabilization and osteosynthesis. ⋯ While transoral intraoperative reduction of a partially displaced odontoid fracture has previously been described, the authors present the first case utilizing this technique in the treatment of a completely dislocated type II odontoid fracture.
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Acta neurochirurgica · Oct 2009
Reducible and irreducible os odontoideum in childhood treated with posterior wiring, instrumentation and fusion. Past or present?
The aim of the study was to evaluate the results of instrumented rod and wire fusion in children with craniovertebral junction (CVJ) instability and os odontoideum. ⋯ A wiring technique to correct atlantoaxial instabilities has been shown to be more relevant in these children with syndromic atlantoaxial dislocation and os odontoideum due to its simplicity, safety (continuous fluoroscopic assistance is not necessary and there is no risk of neuro-vascular injuries) and lower costs (no complex hardware devices; no neuronavigation systems are required). Preoperative irreducibility of the C1-C2 shift is not an absolute criterion for transoral decompression in children since os odontoideum can be reduced under general anesthesia.
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Acta neurochirurgica · Oct 2009
Validity of the frontolateral approach as a minimally invasive corridor for olfactory groove meningiomas.
Several approaches are described for olfactory groove meningiomas (OGMs) varying from a very wide bifrontal craniotomy to minimally invasive endoscopic techniques. The goal of this study was to evaluate the results of the frontolateral approach for olfactory groove meningioma. Pitfalls related to this corridor will be described. The impact of tumor size and encasement of the anterior cerebral artery complex on the degree of tumor removal will be described on the basis of experience with 18 cases. ⋯ The frontolateral approach has the advantages of both the pterional and conventional bifrontal approaches. The frontolateral approach allows quick and minimally invasive access to OGMs less than 4 cm in diameter, and also to tumors more than 4 cm in diameter without encasement of the anterior cerebral artery complex. Tumor size more than 4 cm in diameter and encasement of the anterior cerebral artery complex are limiting factors for the frontolateral approach if radical tumor removal is considered.