Acta neurochirurgica
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Acta neurochirurgica · Dec 2007
Outcome of adult patients with temporal lobe tumours and medically refractory focal epilepsy.
Tumours are a well-recognized cause of medically intractable epilepsies. Tumours represent the primary pathology in 10%-30% of patients undergoing surgical treatment for chronic epilepsy. This study examines the surgical and epileptological outcome of adults with temporal lobe tumoural epilepsy treated within a comprehensive epilepsy surgery programme. ⋯ Patients with drug resistant epilepsy and temporal lobe tumours should undergo evaluation in dedicated epilepsy surgery programmes.
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Acta neurochirurgica · Dec 2007
Case ReportsDecompressive craniectomy for massive cerebral infarction with enlarged cruciate duraplasty.
The use of decompressive craniectomy for massive cerebral infarction is attracting renewed interest because conventional medical treatment is associated with high mortality. The technique of duraplasty may be important. ⋯ None of the patients needed an additional anterior temporal lobectomy to reduce intraoperative intracranial pressure and none suffered epilepsy after the operation. This initial experience suggests that the use of a stepwise cruciate duraplasty during a decompression may promote clinical outcomes and further evaluation is merited.
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Acta neurochirurgica · Nov 2007
Randomized Controlled TrialErythropoietin in patients with aneurysmal subarachnoid haemorrhage: a double blind randomised clinical trial.
Erythropoietin (EPO) is neuroprotective in experimental models of stroke and subarachnoid haemorrhage (SAH) and possibly in patients with thromboembolic stroke. We studied the efficacy and safety of EPO in patients with SAH. ⋯ Beneficial effects of EPO in patients with SAH cannot be excluded or concluded on the basis of this study and larger scale trials are warranted.
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Acta neurochirurgica · Nov 2007
Diffusion tensor imaging and white matter tractography in patients with brainstem lesions.
Diffusion tensor imaging (DTI) and white matter tractography (WMT) are promising techniques for estimating the course, extent, and connectivity patterns of the white matter (WM) structures in the human brain. In this study, we investigated the ability of DTI and WMT to visualize white matter tract involvement for the preoperative surgical planning and postoperative assessment of brainstem lesions. ⋯ Compared with the information provided by conventional MR imaging, DTI and WMT provided superior quantification and visualization of lesion involvement in eloquent fibre tracts of the brainstem. Moreover, DTI and WMT were found to be beneficial for white matter recognition in the neurosurgical planning and postoperative assessment of brainstem lesions.
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Acta neurochirurgica · Nov 2007
Primary CNS lymphoma treated with combined intra-arterial ACNU and radiotherapy.
To assess whether nimustine (ACNU), a drug that can cross the blood brain barrier, combined with radiotherapy, improved the survival of patients with primary central nervous system lymphoma (PCNSL). ⋯ The intra-arterial administration of ACNU combined with radiation therapy yielded a high response rate at acceptable toxicity levels in younger patients with PCNSL. However, late neurotoxicity was a serious complication in patients above 60 years of age.