Acta neurochirurgica
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Acta neurochirurgica · Nov 2005
Case ReportsIntensity-modulated radiosurgery for childhood arteriovenous malformations.
Presentation of intensity-modulated radiosurgery (IMRS) for the treatment of inoperable, complex shaped pediatric arterio-venous malformations AVM. ⋯ IMRS can allow for highly conformal planning and delivery of radiosurgery radiation doses even if pediatric AVM target volumes are large and/or highly complex in shape. This technique has been seen to result in favorable preliminary outcomes, thus supporting future exploration of this technique in pediatric and adult patients.
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Acta neurochirurgica · Nov 2005
Case ReportsDistal posterior inferior cerebellar artery aneurysms: clinical characteristics and surgical management.
Aneurysms located on the distal posterior inferior cerebellar artery (PICA) are rare, and their underlying clinical features and surgical management are poorly understood. We report our series of 16 patients with 18 distal PICA aneurysms. ⋯ Most of our cases of ruptured distal PICA aneurysms presented with haematocephalus. These were frequently associated with another vascular abnormality and 22% were fusiform or multilobulated. These specific features require special management strategies entailing an appropriate surgical approach to the aneurysm, clipping method, haematoma removal, ventricular drainage and when suitable choice of endovascular interventions.
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Acta neurochirurgica · Nov 2005
Case ReportsLumbosacral spinal epidural abscess caused by Brucella melitensis.
Spinal epidural abscess is a rare condition that can lead to irreversible complications and death if untreated. Rarely, Brucella melitensis may produce spondylodiscitis, which may be complicated by spinal epidural abscess. We report a case of lumbosacral spinal epidural abscess caused by Brucella melitensis. Spinal brucellosis should be kept in mind in the differential diagnosis of low back pain.
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Acta neurochirurgica · Oct 2005
Comparative StudyIntraventricular or lumbar infusion test in adult communicating hydrocephalus? Practical consequences and clinical outcome of shunt operation.
To investigate the therapeutic consequences of restricting the CSF dynamic evaluation to a lumbar infusion test (LIT), as opposed to our formerly applied intraventricular assessment (VIT), in patients with communicating hydrocephalus (CH). ⋯ LIT and VIT are equally reliable for selecting shunt responsive patients with CH, using clinical improvement rate as the main criterion for comparison. The practical and economic consequences are substantial: the LIT can be performed in an outpatient setting, whereas VIT necessitates hospitalisation for 1-2 days including occupation of the neurosurgical theatre and postoperative neuro-intensive monitoring.