Acta neurochirurgica
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Acta neurochirurgica · Dec 2006
Micro-vascular decompression for primary Trigeminal Neuralgia (typical or atypical). Long-term effectiveness on pain; prospective study with survival analysis in a consecutive series of 362 patients.
Few publications on primary Trigeminal Neuralgia treated by Micro-Vascular Decompression (MVD) report large series, with long-term follow-up, using Kaplan-Meier (K-M) analysis. None was specifically directed to the comparative study of MVD effectiveness on Trigeminal Neuralgia with typical (i.e., with paroxysmal pain only) and atypical features (i.e., with association of a permanent background of pain). ⋯ Pure MVD offers patients affected by Trigeminal Neuralgia due to vascular compression a long-lasting cure in three-fourths of the cases. Both typical and atypical presentations respond well to MVD, view in contrast to the classical view that an atypical presentation has an adverse effect on outcome after surgery.
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Acta neurochirurgica · Dec 2006
Historical ArticleNeurosurgical practice at Başkent University, Turkey: a new model.
The Turkish Organ Transplantation and Burn Foundation was established in 1980. This was followed by the founding of the Turkish Transplantation and Burn Foundation Hospital in 1985. Under the aegis of this foundation and the Haberal Educational Foundation, Baskent University (BU) was founded in 1993 by Professor Mehmet Haberal, general surgeon and pioneer of organ transplantation in Turkey, and the President of the university since then. ⋯ BU as a whole and its health system model in particular are certainly unique in Turkey. The statistical data from all hospitals of the BU reveal growing patient demand and consumer satisfaction.
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Eight cases of neurosurgical operations being performed on the wrong side were studied. Safeguards of confidentiality were used. In seven cases side marking was not done and the surgeons felt that had it been done, the mistake would have or may have been prevented. ⋯ In the one case where the check was carried out the mistake was made because the patient had been marked on the wrong side. In no case was the mistake made because of ambiguous or absent site data in the imaging or notes. It is concluded that to prevent these mistakes emphasis should be placed on ensuring that the preoperative site check is completed more than on ensuring that unambiguous side information is available in the notes and imaging.
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Acta neurochirurgica · Dec 2006
Case ReportsRuptured intracranial aneurysm following gamma knife surgery for acoustic neuroma.
A-63-year-old woman underwent gamma knife surgery (GKS) for acoustic neuroma. Six years later, she suffered sudden onset of severe headache followed by a disturbance of consciousness and subarachnoid haemorrhage due to a ruptured aneurysm originating from the distal anterior inferior cerebellar artery. ⋯ The aneurysm was treated by endovascular embolization, and now, 15 months later, the patient has recovered satisfactorily. This is the first report of aneurysm formation following GKS for acoustic neuroma.
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Acta neurochirurgica · Dec 2006
Intracranial pressure levels and single wave amplitudes, Glasgow Coma Score and Glasgow Outcome Score after subarachnoid haemorrhage.
To relate intracranial pressure (ICP) levels and single ICP wave amplitudes to the acute clinical state (Glasgow Coma Score, GCS) and final clinical outcome (Glasgow Outcome Score, GOS) in patients with subarachnoid haemorrhage (SAH). ⋯ In this small patient group the mean ICP wave amplitude during days 1-6 after SAH was related to the acute clinical state (GCS) as well as to the clinical outcome (GOS) 6 months after SAH. Similar relationships were not found for mean ICP or the mean CPP, except for a higher mean ICP in those who died than in those with moderate disability/good recovery.