Acta neurochirurgica
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Acta neurochirurgica · Jun 2003
Comparative Study Clinical TrialThe selective T3 sympathicotomy in patients with essential palmar hyperhidrosis.
Selective T3 thoracoscopic sympathicotomy in patients with essential palmar hyperhidrosis may produce successful results with fewer side effects. We report preliminary results in comparison with those of conventional T2, T3 thoracoscopic sympathicotomy. ⋯ Selective T3 thoracoscopic sympathicotomy results in a decrease in the rate of disturbing side effects compared to conventional T2, T3 thoracoscopic sympathicotomy without recurrence of symptoms. We suggest that selective T3 thoracoscopic sympathicotomy is the treatment of choice in essential palmar hyperhidrosis.
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To investigate clinical relevance and prognostic value of brain tissue oxygen response (TOR: response of brain tissue pO(2) to changes in arterial pO(2)) in traumatic brain injury (TBI). ⋯ Evaluation of TOR affords insight in (disturbances in) oxygen regulation after traumatic brain injury, is of prognostic value and may aid in identifying patients at (increased) risk for ischemia.
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Acta neurochirurgica · May 2003
Case Reports"Approaches and surgical results in the treatment of ventral thoracic meningiomas. Review of our experience with a postero-lateral combined transpedicular-transarticular approach.".
The surgical treatment of anterior thoracic meningiomas provides a set of technical difficulties: the access is obstructed by the spinal cord posteriorly, thoracic cage and musculature laterally, mediastinum and pleural cavity anteriorly. It is fundamental to avoid any manipulation of the compressed, but also undamaged spinal cord: this shows significant plastic capabilities. Any effort should be directed to maximizing the contribution of the plasticity in order to obtain a good functional recovery. ⋯ We found this surgical exposure very helpful in the treatment of anterior thoracic meningiomas. The related morbidity and risk of instability are minimal. The combined postero-lateral approach offers a good surgical access to ventral, lateral and dorsal aspects of the thoracic spinal canal without manipulation of the spinal cord. Exposure is obtained by avoiding damage to the pleura and manipulation of the lungs and mediastinum and may be a feasible alternative in elderly patients, too.
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Spinal subdural haematoma is a rare condition usually associated with several precipitating factors including coagulopathy, lumbar puncture, trauma, vascular malformation and previous spinal surgery. In this paper we report spinal subdural haematoma related to cranial surgery which is a previously unknown precipitating factor. ⋯ Spinal subdural haematoma is a rare but possible complication of cranial surgery. It should be considered in patients with back pain and radiculopathy in the lower extremity developing after surgery for intracranial lesions. Unlike spontaneous spinal subdural haematoma with other precipitating factors, spinal subdural haematoma developing after cranial surgery takes a benign clinical course and resolves spontaneously over several days to 2 weeks without surgical intervention.
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Acta neurochirurgica · Apr 2003
Large sphenocavernous meningiomas: is there still a role for the intradural approach via the pterional-transsylvian route?
Large-sized sphenocavernous meningiomas represent a surgical challenge. Although the role of skull base techniques with combined extra- and intradural steps has been recently emphasized, pure intradural resection tactics via the pterional route constitute the traditional microsurgical approach for resection of such tumours. ⋯ In our experience, large sphenocavernous meningiomas may be operated on adopting pure intradural resection tactics via the pterional-transsylvian route with rates of gross total removal and surgical complications related to brain retraction or vascular manipulation comparable to those of extensive skull base approaches. The traditional intradural pterional transsylvian approach continues to have a place in the treatment of these lesions.