Acta neurochirurgica
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Acta neurochirurgica · Jan 2001
Review Case ReportsCoagulopathy induced spinal intradural extramedullary haematoma: report of three cases and review of the literature.
In a retrospective review of patients operated for coagulopathy induced spinal intradural-extramedullary haematoma the literature regarding coagulopathy induced spinal haemorrhage is reviewed and the etiology of these rare spinal subdural and subarachnoid haemorrhages is discussed. Spinal intradural haematomas are usually related to trauma or a previous lumbar puncture. ⋯ Coagulopathy induced spinal haemorrhage should be included in the differential diagnosis of acute paraparesis in patients with co-existent haematological disorders or undergoing anticoagulation therapy. Due to the often mixed subdural and subarachnoid bleeding patterns we have termed this entity spinal intradural-extramedullary haematoma.
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Acta neurochirurgica · Jan 2001
Comparative StudyThe effect of hair on infection after cranial surgery.
Reports of large series of patients who had undergone successful cranial neurosurgery without hair removal led part of our team to abandon the practice of shaving patients' heads pre-operatively. The aim of this study was to assess whether this change in routine, which was implemented in 1992, has affected the rate of postoperative infection in our cranial surgery patients. ⋯ Cranial surgery without hair removal is safe and does not increase the risk of surgical wound infection. Patients naturally prefer to keep their full head of hair. We believe that preoperative hair removal is not necessary in preparation for any type of cranial neurosurgery.
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Acta neurochirurgica · Jan 2001
Clinical TrialOpen MRI-guided microsurgery of intracranial tumours in or near eloquent brain areas.
Preservation of brain function while maximizing resection is the main aim of brain tumour surgery. The purpose of this study was to evaluate the efficacy of intra-operative magnetic resonance imaging to preserve brain function in patients with tumours in or near eloquent brain areas. ⋯ Intra-operative MRI is helpful for navigation as well as to demonstrate the tumour margins to achieve a complete and safe resection of intracranial lesions located in or near eloquent brain areas. It enables an image based functional monitoring of the brain which is critical for motor, sensory or language function. Complications related to the surgical procedure are reduced and the risk of neurological deterioration due to tumour removal and postoperative complications is minimized.
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Acta neurochirurgica · Jan 2001
Aggressive surgery and focal radiation in the management of meningiomas of the skull base: preservation of function with maintenance of local control.
Recent study series have reported that post-operative external beam radiation therapy and stereotactic radiosurgery with the linear accelerator or gamma knife improves long-term local control of subtotally resected or recurrent meningiomas. ⋯ These results demonstrate that skull base meningiomas which require treatment can be managed with a combination of aggressive surgery and conformal radiation with an acceptable functional status in 99% of cases.
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Acta neurochirurgica · Jan 2001
Clinical TrialMonitoring of facial evoked EMG for hemifacial spasm: a critical analysis of its prognostic value.
Microvascular decompression (MVD) has come to stay as an effective way of treating hemifacial spasm. But it remains to be seen how much each of the electrophysiological monitoring techniques (intra-operative) are contributing to its increased efficacy. Their role as indicators for re-exploration or recurrence is to be evaluated with more studies. ⋯ Two of 21 patients who had disappearance of abnormal responses had persistent mild HFS; but in all cases, the HFS disappeared within 3 months. So we found that the intra-operative recording was really not reliable in predicting the immediate postoperative outcome. However the outcome at 3 months suggested that waiting for some time before re-exploration is a better option, especially if the HFS had become mild.