Acta neurochirurgica
-
Acta neurochirurgica · Feb 2006
Case Reports Clinical TrialBenefits and limitations of image guidance in the surgical treatment of intracranial dural arteriovenous fistulas.
Despite major advances in endovascular embolization techniques, microsurgical resection remains a reliable and effective treatment modality for dural arteriovenous fistulas (DAVF). However, intraoperative detection of these lesions and identification of feeding arteries and draining veins can be challenging. In a series of 6 patients who were not candidates for definitive treatment by endovascular embolization we evaluated the benefits and limitations of computer-assisted image guidance for surgical ablation of DAVF. ⋯ Neuronavigation may be used as an additional tool for microsurgical treatment of DAVF. However, in this small series of 6 cases, surgical procedures have not been substantially altered by the use of the neuronavigation system. Image guidance has been beneficial for the location of small, superficially located DAVF, whereas a navigated approach to deep-seated lesions was less accurate due to the familiar problem of brain shift and brain retraction during surgery.
-
Acta neurochirurgica · Feb 2006
Case Reports Clinical TrialThe use of ultrasonic bone curettes in spinal surgery.
The author describes a clinical applications, procedure, and efficacy of ultrasonic bone curette (UBC) (bone-removal bar) in spinal surgery. ⋯ This system appears to be versatile, safe, and efficient in spinal surgery and could be improved by the development of a better handpiece.
-
Acta neurochirurgica · Feb 2006
Clinical TrialMultimodal protocol for awake craniotomy in language cortex tumour surgery.
Intra-operative neurophysiological language mapping has become an established procedure in patients operated on for tumours in the area of the language cortex. Awake cranial surgery has specific risks and patients are exposed to an increased physical and mental stress. The aim of the study was to establish an algorithm that enables tailoring the neurosurgical and anaesthetic techniques to the individual patient. ⋯ The multimodal protocol for awake craniotomy provides for tumour resection under general anaesthesia in selected patients using functional neuronavigation. Our experience with the algorithm suggests that it is a useful tool for preserving function in patients undergoing surgery of the language cortex while reducing the operative risk on an individual basis.
-
Acta neurochirurgica · Feb 2006
Predictive factors for arm pain, neck pain, neck specific disability and health after anterior cervical decompression and fusion.
Predictive factors for a low arm and neck pain, and good health after anterior cervical decompression and fusion (ACDF) with a cervical carbon fibre intervertebral fusion cage (CIFC) are still lacking. ⋯ Non-smoking, a low pain level and normal rating on DRAM were the best preoperative predictors of a good outcome in ACDF. Inclusion criteria for surgery should be based on a bio psychosocial model and DRAM seems to be useful for including the traditional inclusion criteria.
-
Acta neurochirurgica · Feb 2006
Case ReportsLong-term follow-up of giant serpentine MCA aneurysm treated with EC-IC bypass and proximal occlusion.
Giant serpentine aneurysms are a rare but important subset of giant aneurysms, with unique management considerations. We present long-term follow-up clinical and imaging features of a giant serpentine middle cerebral artery lesion treated with extracranial-intracranial bypass and proximal occlusion more than a decade earlier. Calcification of the obliterated aneurysm sac and durability of this management strategy are demonstrated.