Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · May 2011
Treatment of ruptured internal carotid artery trunk aneurysms: feasibility of endovascular trapping or proximal obliteration of the ICA.
Ruptured aneurysms arising from non-branching sites of the internal carotid artery (ICA) are often difficult to treat by neck clipping or endosaccular coiling. We discuss the feasibility of simple endovascular ICA ligation or trapping to treat aneurysms. ⋯ Seven of eleven patients could be treated by endovascular ICA trapping or ligation, which offers a simple, safe method for ruptured ICA trunk aneurysms, if collateral capacity is good and neurological condition is not serious.
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Clin Neurol Neurosurg · May 2011
Comparative StudyFacial sensibility of patients with trigeminal neuralgias.
Idiopathic trigeminal neuralgia (ITN) is an excruciating shock-like paroxysmal pain restricted to the trigeminal area of innervation, with discrete loss of sensibility (thermal, tactile and painful). Trigeminal postherpetic neuralgia (PHN) is a neuropathic pain at the trigeminal territory that persists after Herpes zoster infection, which also is associated to sensorial compromise. The objective of this study was to evaluate the somesthetic facial sensibility (pain, thermal and tactile) and to compare the findings between PHN and ITN. ⋯ The trigeminal area affected by the disease had the higher sensorial losses (ophthalmic branch in PHN and maxillary/mandibular branches in ITN). PHN patients had losses in large and small fibers; therefore, ITN patients had the losses mostly in large fibers, which support different peripheral neural mechanisms for these neuropathic diseases.
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Clin Neurol Neurosurg · May 2011
Polypropylene-polyester cranial prostheses prepared with CAD/CAM technology. Report of first 15 cases.
The authors described a new cranioplastic method where polypropylene-polyester knitwear was shaped according to individual patient's skull 3D model. The material was formed in a customized manner and preoperatively adjusted to the patient needs with modern CAD/CAM techniques. ⋯ CAD/CAM shaping gave better adjustment to requirements of specific defect than any standard preformed plate. Such method seemed to be a reasonable alternative to other cranioplastic solutions and can be recommended even for cases of large or complicated shape cranioplasties.
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Clin Neurol Neurosurg · May 2011
The importance of the greater occipital nerve in the occipital and the suboccipital region for nerve blockade and surgical approaches--an anatomic study on cadavers.
Greater occipital nerve (GON) blockade is an effective method for treatment of occipital neuralgias. Occipital neuralgia or neuropraxis of this region may be seen particularly as a result of compression of the GON. This study shows the relationship between the GON and its external bone landmarks, in order to prevent complications and to perform nerve blockades safely. The study also defines the points where the GON pierces the semispinalis capitis (SSC) and the trapezius, and where the GON passes the obliquus capitis inferior (OCI), and identifies bone landmarks for places where the GON may be entrapped. ⋯ In this study, we define the GON's route in the suboccipital and the occipital region where the nerve pierces the SSC and the AT and where blockade or surgery can be performed. These data will help the surgeon and clinician to avoid complications in this region.