Journal of neurological surgery. Part A, Central European neurosurgery
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J Neurol Surg A Cent Eur Neurosurg · Sep 2013
Case ReportsGlossopharyngeal neuralgia treated with an endoscopic assisted midline suboccipital subtonsillar approach: technical note.
Glossopharyngeal nerve neuralgia (GPN) is an exceptionally rare skull-based disorder. It is treated similar to other neurovascular conflicts. The approach, however, is debatable, as the caudal cranial nerves and especially the exit zones at the brainstem are barely visible via the retrosigmoid approach. ⋯ A midline subtonsillar approach with endoscopic assistance to the lateral brainstem is a straightforward time- and morbidity-sparing procedure.
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J Neurol Surg A Cent Eur Neurosurg · Sep 2013
Case ReportsConversion of local anesthesia-guided deep brain stimulation of the subthalamic nucleus to general anesthesia.
Deep brain stimulation of the subthalamic nucleus (STN) is a widely applied procedure in the treatment of patients with advanced Parkinson disease and is generally performed under local anesthesia. Here we report our experience with the conversion to general anesthesia in two patients with advanced Parkinson disease because of fear reactions intraoperatively. ⋯ Our case observations document the possibility of fear reactions intraoperatively and show the possibility of conversion to general anesthesia with a successful outcome.
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J Neurol Surg A Cent Eur Neurosurg · Jul 2013
Neuronavigation-assisted endoscopic unilateral cyst fenestration for treatment of symptomatic septum pellucidum cysts.
Traditional surgical treatments for this rare disease include open surgical procedures and ventriculoperitoneal shunting. In 1995, endoscopic fenestration was first applied to treatment of cysts of the septum pellucidum (CSP). However, cyst fenestration generally takes a bilateral approach by making two burr holes leading to two fenestrations in the lateral walls of the cyst. Some disadvantages are related to bilateral fenestration. So far, there is no consensus on the surgical indications, the endoscopic approaches, and techniques for CSPs. Based on our experience with 14 cases of symptomatic CSP treated with neuronavigation-assisted endoscopic unilateral cyst fenestration via a single burr hole, we discuss the operative indications and the utility of endoscope-assisted techniques in combination with neuronavigation. ⋯ The results after uni- and bilateral CSP fenestration show no significant difference. Avoiding damage of contralateral tissue, the surgical trauma in unilateral fenestration is less than in bilateral fenestration. Furthermore, the unilateral approach shortens the operation time. We believe that unilateral cyst fenestration is a better therapeutic option in symptomatic CSP.
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J Neurol Surg A Cent Eur Neurosurg · Jul 2013
Case ReportsMinimally invasive, robot-assisted, anterior lumbar interbody fusion: a technical note.
Minimally invasive techniques in spine surgery have gained significant popularity due to decreased tissue dissection and destruction, postoperative pain, and hospital stay. The laparoscopic anterior lumbar interbody fusion (ALIF), an innovation in minimally invasive spine surgery, is rarely done because it has marginal benefit over the mini-open ALIF technique in rates of retrograde ejaculation and vascular complications. We propose these outcomes can be improved with enhanced robotic-assisted dissection and exposure for ALIF. ⋯ Use of the robotic assistance in the performance of ALIF is possible without significant operative complications. This technique may provide added benefit over conventional laparoscopic approaches to the spine.