Acta neurochirurgica
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Acta neurochirurgica · Jul 2014
Treatment of patients with ruptured aneurysm by neurosurgeons that perform both open surgical and endovascular techniques is safe and effective: results of a single centre in Europe.
In Europe only few neurosurgeons are trained in both open surgical clipping as well as in endovascular techniques for treatment of intracranial aneurysms. To investigate the safety and efficacy of performing both techniques we, two dual trained neurosurgeons, analyzed our results in repairing ruptured intracranial aneurysms. Prospectively collected data from 356 patients that underwent open surgical or endovascular repair of a ruptured intracranial aneurysm at the Neurosurgical Centre Nijmegen from 2006 to 2012 by two dual trained neurosurgeons were retrospectively analyzed. ⋯ One aneurysm was retreated. Treatment of ruptured intracranial aneurysms by neurosurgeons that perform both open surgical clipping as well as endovascular techniques is safe and effective. Developing training programs in Europe for hybrid neurosurgeons that can provide comprehensive patient care should be considered.
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Acta neurochirurgica · Jul 2014
The Frankfurt horizontal plane as a reference for the implantation of gravitational units: a series of 376 adult patients.
The in-line combination of adjustable differential pressure valves with fixed gravitational units is increasingly recommended in the literature. The spatial positioning of the gravitational unit is thereby decisive for the valve opening pressure. We aimed at providing data on factors contributing to primary overdrainage and underdrainage of cerebrospinal fluid (CSF), with special attention paid to the implantation angle of the gravitational unit. ⋯ The implantation of the gravitational unit of the proGAV valve within a range of at least 10° in regard to the vertical line to the Frankfurt horizontal plane does not seem to predispose patients to primary overdrainage or underdrainage in ventriculoperitoneal shunting. The plane may serve as a useful reference for the surgeon's orientation.
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Acta neurochirurgica · Jul 2014
Transsphenoidal surgery for acromegaly: predicting remission with early postoperative growth hormone assays.
Early detection of residual disease may benefit management strategies in patients undergoing transsphenoidal surgery for acromegaly. This requires establishing objective thresholds for early postoperative growth hormone (GH) assays, and incorporating these parameters into a scale for outcome prediction. ⋯ Early postoperative GH assays are highly sensitivity and specific. The scoring system that we propose provided excellent predictive value and requires further validation in larger cohorts and in different populations. The model may help guide the intensity of follow-up and enable early identification of residual disease.
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Acta neurochirurgica · Jul 2014
Changes in number of water-filled vesicles of choroid plexus in early and late phase of experimental rabbit subarachnoid hemorrhage model: the role of petrous ganglion of glossopharyngeal nerve.
Cerebrospinal fluid (CSF) secretion may be increased in the early phases of subarachnoid hemorrhage (SAH), possibly via ischemic glossopharyngeal nerve discharges, and decreased due to glossopharyngeal nerve degeneration in the late phase of SAH; but this reflex pathway has not been definitively investigated. We studied the relationship between petrous ganglion of the glossopharyngeal nerve (GPN) and water vesicles of the choroid plexus (CP) in the early and late phases of SAH. ⋯ We studied the relationship between petrous ganglion cells of the GPN and water vesicles of CP in the early and late phases of SAH, and found that CP vesicles are increased in the early phase of SAH due to irritation of GPN, and decreased in the late phase due to ischemic insult of the petrous ganglion and parasympathetic innervation of the CP.