Acta neurochirurgica
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Acta neurochirurgica · Oct 2008
Complications during and after surgery of the lower cervical spine by isolated anterior approach with CSLP implant.
The merits of different operative approaches in the management of spinal injury is debated. The aim of this study was to assess, retrospectively, the outcome of treatment of injuries of the lower cervical spine by an anterior approach, in terms of fusion rate and complications. ⋯ Treatment of the injured lower cervical spine by an anterior operation and plate fixation was successful in achieving bone fusion in almost every patient and was followed by a complication in only a small proportion of our series. Similar results in other reports indicate that this approach is a safe and effective procedure.
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Acta neurochirurgica · Oct 2008
Case ReportsDecompressive craniectomy for medically refractory intracranial hypertension due to meningoencephalitis: report of three patients.
Meningoencephalitis may sometimes cause medically refractory intracranial hypertension and brain herniation. In such patients death is common. There are a limited number of reports on the use of decompressive craniectomy as a life saving measure in these circumstances with some good results. The aim of the study was to report experience in three further patients. ⋯ Surgery resulted in an immediate reduction of intracranial pressure in two of the three patients with severe meningoencephalitis. Decompressive craniectomy may be a useful option in the management of a patient with medically refractory intracranial hypertension caused by meningoencephalitis. Early intervention may enhance its benefits.
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Acta neurochirurgica · Sep 2008
Surgical strategies for giant medial sphenoid wing meningiomas: a new scoring system for predicting extent of resection.
Surgical management of giant medial sphenoid meningiomas (> or =5 cm in maximum dimension) is extremely challenging due to their intimate relationship with vital neural structures like the optic nerve, cranial nerves of the cavernous sinus and the cavernous internal carotid artery. Their surgical management is presented incorporating a radiological scoring system that predicts the grade of tumour excision. ⋯ A relatively conservative approach to these extensive lesions resulted in good outcome in a majority of our patients. Both the standard as well as skull base approaches may be utilized for successful removal of giant medial sphenoidal wing meningiomas. A preoperative radiological score of > or =7 predicts a greater degree of difficulty in achieving complete surgical extirpation.