Journal of neurosurgery
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Journal of neurosurgery · Jul 1998
Multicenter Study Comparative Study Clinical TrialEndovascular embolization of 150 basilar tip aneurysms with Guglielmi detachable coils: results of the Food and Drug Administration multicenter clinical trial.
To assess the safety and efficacy of aneurysm embolization performed using Guglielmi detachable coils (GDCs), the authors reviewed the results of a cohort of 150 patients with either ruptured (83 patients) or unruptured (67 patients) basilar tip aneurysms treated with these detachable platinum coil devices in the early part of the United States multicenter GDC clinical trial that led to Food and Drug Administration approval for the device. ⋯ Detachable platinum coil embolization is a promising treatment for ruptured basilar tip aneurysms that are not surgically clippable; in selected patients it offers lower incidences of morbidity and mortality compared with conservative medical management. The role of this procedure in unruptured basilar tip aneurysms is unclear with less supportive results. More long-term follow-up evaluation is necessary and results are expected to improve.
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Journal of neurosurgery · Jul 1998
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialCurrent neurosurgical management and the impact of the extent of resection in the treatment of malignant gliomas of childhood: a report of the Children's Cancer Group trial no. CCG-945.
One hundred seventy-two children with high-grade astrocytomas were treated by members of the Children's Cancer Group in a prospective randomized trial designed to evaluate the role of two chemotherapy regimens. Seventy-six percent of the patients (131 children) in whom a diagnosis of either anaplastic astrocytoma or glioblastoma multiforme was confirmed by central pathological review are the subject of this report. ⋯ The demonstration of a survival advantage provided by radical resection should prompt neurosurgeons to treat malignant pediatric astrocytomas with aggressive surgical resection prior to initiation of radiotherapy or adjuvant chemotherapy.
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Journal of neurosurgery · Jul 1998
Long-term follow-up review of patients who underwent laminectomy for lumbar stenosis: a prospective study.
Decompressive laminectomy for stenosis is the most common operation performed in the lumbar spine in older patients. This prospective study was designed to evaluate long-term results in patients with symptomatic lumbar stenosis. ⋯ In conclusion, long-term improvement after laminectomy was maintained in two-thirds of these patients.
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Journal of neurosurgery · Jul 1998
Posterior ventricular catheter burr-hole localizer. Technical note.
Proper ventricular catheter placements are associated with improved shunt performance. When placing ventricular catheters via the posterior approach, the surgeon must determine an optimum trajectory and then pass a catheter along that trajectory. The incidence of optimal posterior catheter placements is increased by using a posterior catheter guide (PCG); however, errors may still occur because of poor selection of a posterior burr-hole site. ⋯ In all cases the catheter entered the ventricle on the first pass and postoperative imaging studies demonstrated successful placement in the ipsilateral anterior horn. There were no catheter-related complications. These early results indicate that the Localizer and PCG devices may be safe and effective when used in combination for placement of posterior ventricular catheters.