Acta neurochirurgica
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Acta neurochirurgica · Mar 2005
Treatment of spontaneous arterial dissections with stent placement for preservation of the parent artery.
A wide variety of treatment regimens have been advocated for dissections involving the intracranial arteries. Recently, the stent can be used to exclude the aneurysm from the circulation and preserve the parent artery. We evaluated the safety and efficacy of stent angioplasty for intracranial arterial dissections. ⋯ The success in reducing dissection-induced stenosis or pseudo-aneurysm, the patency rate obtained at follow-up, and the lack of strokes (ischaemic or haemorrhagic) suggest that stent placement offers a viable alternative to complex surgical procedures or deconstructive procedures. The long-term efficacy and durability of stent placement for arterial dissection remains to be determined in a large series.
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Acta neurochirurgica · Mar 2005
Clinical TrialImproved brain protection at decompressive craniectomy--a new method using Palacos R-40 (methylmethacrylate).
A new method is described for protecting the brain after decompressive craniectomy in which a temporary methylmethacrylate flap is formed, somewhat larger than the original bone flap, thus gaining "extra" volume for the oedematous brain in which to expand. The present procedure was developed as a part of ordinary clinical practice particularly in response to demands from the NICU staff and our colleagues at other clinics who were responsible for the care of the patient in the post NICU period. They made us keenly aware that these patients frequently lack optimal co-ordination and balance and therefore run an increased risk of trauma to the unprotected brain when falling. This prompted us to develop a method for brain protection after decompressive craniectomy aiding in the care and rehabilitation until the final installation of the patient's own bone flap can be performed.
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Acta neurochirurgica · Feb 2005
Case ReportsSuccessful resection of a left insular cavernous angioma using neuronavigation and intraoperative language mapping.
Despite recent literature advocating the surgical removal of symptomatic Cavernous Angiomas (CA), even in critical brain areas, very few observations of insular CA surgery have been described, particularly in the left hemisphere. We report the case of a successful resection of a CA located in the dominant insula, using both neuronavigation and intra-operative functional mapping. This 33-year-old right-handed man harbored a left insular CA, revealed by generalized seizures following a bleed confirmed on MRI. ⋯ There was no postsurgical deficit, nor any seizure without treatment (follow-up: 4.5 years). The diagnosis of CA was confirmed by histological examination. Taking account of the risk of morbidity due to the natural history of CA, particularly in eloquent brain regions, we suggest to routinely consider the possibility of a surgical treatment in cases of symptomatic (left dominant) insular CA, using combined intra-operative anatomical and physiological localization methods.
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Acta neurochirurgica · Feb 2005
Case ReportsMultiple cystic cavernous angiomas associated with hemorrhage.
A 29-year-old man presented with impaired mental concentration and inability to remember. Magnetic resonance and computed tomography studies revealed multiple calcified cysts. ⋯ The histological diagnosis was cavernous angioma. The first report of multiple cystic cavernous angiomas is reported.