Acta neurochirurgica
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Acta neurochirurgica · Jun 2016
Review Case ReportsCyst-cisternal shunting for cystic multirecurrent brainstem epidermoid: case report and literature review.
Surgical treatment of recurrent, posterior cranial fossa epidermoids in multioperated patients carries significant morbidity, mainly due to tumor adhesion to cranial nerves and vessels, and brainstem involvement. Radical resection is often not feasible; therefore surgery should aim to restore cerebrospinal fluid circulation, release engulfed neurovascular structures, and relieve brainstem compression. Intra-axial epidermoids are extremely rare. We present an innovative surgical technique of a cyst-cisternal shunting to treat cystic recurrent, unresectable brainstem epidermoids. ⋯ Cyst-cisternal shunting in case of recurrent, brainstem epidermoid is a safe and long-term effective technique to relieve mass effect into the brainstem.
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Acta neurochirurgica · May 2016
Percutaneous radiofrequency thermocoagulation of dorsal ramus branches as a treatment of "lumbar facet syndrome"--How I do it.
Low back pain is an extremely common and often chronic condition. In some cases, this is due to an irritative arthropathy of zygapophyseal joint involving the medial branch of the dorsal ramus of the spinal nerve. Percutaneous radiofrequency thermocoagulation appears to be the most effective treatment to date, among a range of different treatments. In this paper, the technique is described as performed at out institution. ⋯ Fluoroscopic-guided percutaneous radiofrequency thermocoagulation of dorsal rami branches is a safe and reliable technique for the treatment of lumbar facet syndrome. Careful selection of patients based on clinical presentation and positive anesthetic block test are key points for an optimum outcome.
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Acta neurochirurgica · May 2016
Management and outcome of low velocity penetrating head injury caused by impacted foreign bodies.
Penetrating head injuries with impacted foreign bodies are rare, associated with a high incidence of morbidity and potentially life-threatening. In this study, we aimed at investigating the outcome of these cases as well as analyzing the factors affecting the prognosis. ⋯ Low-velocity penetrating head injuries are most common in young adult males. With the appropriate management, a majority of even the most severe cases can have a favorable outcome.
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Acta neurochirurgica · May 2016
Younger age predicts greater effectiveness of spinal cord stimulation for chronic pain.
Spinal cord stimulation (SCS) is an accepted surgical treatment for neuropathic pain in failed back syndrome or complex regional pain syndrome. However, even in the best selected surgical cases the predictors of adequate pain control are not well defined. The aim of this study was to identify predictors of outcome in patients who underwent SCS in our center. ⋯ Our results suggest that younger age is associated with greater long-term effectiveness of spinal cord stimulation and therefore age may influence the success of SCS therapy with older patients having a greater tendency to failure. Earlier intervention may be beneficial in these chronic pain patients.