Journal of neurological surgery. Part A, Central European neurosurgery
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J Neurol Surg A Cent Eur Neurosurg · Jul 2014
Endoscopic endonasal transphenoidal surgery using the BrainLAB® Headband for navigation without rigid fixation.
The number of lesions of the skull base currently resected via endoscopic, endonasal, transphenoidal approach has increased. We have successfully treated 63 consecutive patients with pituitary lesions using this technique in combination with BrainLAB reference headband and laser surface scanning (BrainLAB(®), Heimstetten, Germany) for surgical navigation. ⋯ This is particularly important, as extension and flexion of the head provide greater exposure to the clivus and anterior skull base, respectively. Also, we demonstrate that this technique is safe, easy-to-use, and faster compared with other ones.
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J Neurol Surg A Cent Eur Neurosurg · Jul 2014
Review Case ReportsMinimally invasive lateral retroperitoneal corpectomy for treatment of focal thoracolumbar kyphotic deformity: case report and review of the literature.
Corpectomy is a frequently performed procedure for pathologies of the anterior spine including neoplasms, fractures, deformities, and osteomyelitis. Traditional approaches to the anterior thoracic spine and thoracolumbar junction are associated with significant perioperative pulmonary complications and morbidity. Posterior and posterolateral approaches minimize some of these complications but are somewhat limited in visualization of the anterior elements. ⋯ Minimally invasive lateral corpectomy is a safe and effective option for deformity correction. We discuss the relative advantages and disadvantages of this approach and review the relevant literature.
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J Neurol Surg A Cent Eur Neurosurg · Jul 2014
Preoperative predictable factors for the occurrence of adjacent segment degeneration requiring second operation after spinal fusion at isolated L4-L5 level.
Retrospective study. ⋯ Age, BMI, and preexisting stenosis at the cranial adjacent segment were the most important risk factors for clinical ASD requiring a second operation. Careful consideration is warranted when these risk factors are present.
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J Neurol Surg A Cent Eur Neurosurg · Jul 2014
An analysis of 88 patients with diffuse and "benign" perimesencephalic subarachnoid hemorrhage.
Perimesencephalic subarachnoid hemorrhage (PMSAH) was previously defined as a variant of subarachnoid hemorrhage (SAH) associated with a relatively benign clinical presentation and better outcomes than aneurysmal SAH. However, several prior studies have shown complications associated with PMSAH including vasospasm and hydrocephalus, and the need for follow-up imaging. We therefore reviewed our experience to further characterize the clinical consequences of PMSAH. ⋯ Our data demonstrate that although the patients with perimesencephalic SAH fared better than those with diffuse SAH, their outcomes were worse than those of similar patients with PMSAH who have been previously reported in the literature.
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J Neurol Surg A Cent Eur Neurosurg · Jul 2014
Epilepsy, headache, and quality of life after resection of cerebral arteriovenous malformations.
In ruptured and unruptured arteriovenous malformations (AVMs), bleeding and re-bleeding rate and efficacy of microsurgical, endovascular, and radiosurgical treatment to prevent hemorrhage are well known. Uncertainty exists concerning the benefit of therapy with regard to headache, epilepsy, and quality of life (QoL) in unruptured AVMs. The objective of the present study was to gain long-term follow-up information after microsurgical AVM resection, in particular with regard to epilepsy, headache, and QoL. ⋯ SF-36-based QoL scores after treatment of AVM differ little from the age-matched German averages. The long-term results regarding chronic epilepsy and chronic headache need further analysis.