Journal of neurosurgery
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Journal of neurosurgery · Nov 2004
Contralateral motor rootlets and ipsilateral nerve transfers in brachial plexus reconstruction.
The goal of this study was to evaluate outcomes in patients with brachial plexus avulsion injuries who underwent contralateral motor rootlet and ipsilateral nerve transfers to reconstruct shoulder abduction/external rotation and elbow flexion. ⋯ Motor rootlet transfer represents a reliable and potent neurotizer that allows the reconstruction of abduction and external rotation in partial injuries.
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Journal of neurosurgery · Nov 2004
Stereotactic radiotherapy for the treatment of acoustic neuromas.
The authors sought to assess the safety and efficacy of stereotactic radiotherapy when using a linear accelerator equipped with a micromultileaf collimator for the treatment of patients with acoustic neuromas. ⋯ Stereotactic radiotherapy using field shaping for the treatment of acoustic neuromas achieves high rates of tumor control and preservation of useful hearing. The technique produces low rates of damage to the fifth and seventh cranial nerves. Long-term follow-up studies are necessary to confirm these findings.
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Journal of neurosurgery · Nov 2004
Case ReportsSubtemporal decompression for slit-ventricle syndrome: successful outcome after dramatic change in intracranial pressure wave morphology. Report of two cases.
Subtemporal decompression is recognized as an effective treatment for slit-ventricle syndrome; however, the effects of this procedure have not been demonstrated using both pre- and postsurgical intracranial pressure (ICP) monitoring. The authors report two cases in which slit-ventricle syndrome and elevated ICP had been diagnosed. Each patient underwent ICP monitoring before and after subtemporal decompression; the dramatic changes in the ICP measurements are presented along with findings from 1-year follow-up examinations.
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Journal of neurosurgery · Nov 2004
Foramen magnum cerebrospinal fluid flow characteristics in children with Chiari I malformation before and after craniocervical decompression.
The Chiari I malformation presents significant challenges to clinicians because its pathophysiology is not well understood. In conducting cerebrospinal fluid (CSF) flow studies, investigators have attempted to correlate the clinical severity of these lesions with general flow velocity or bulk flow at the foramen magnum; however, these techniques have not allowed consistent prediction of symptomatology, explanation of the presence of syringomyelia, or the assessment of the hydrodynamic characteristics of the decompression. The authors used temporally and spatially resolved flow analyses to assess the characteristics of CSF flow in children with Chiari I malformation and the changes in these flow characteristics that occur after suboccipital decompression. ⋯ Foramen magnum CSF flow in children with symptomatic Chiari I malformations is spatially and temporally heterogeneous, and this heterogeneity improves postoperatively. The authors propose that relying on mean flow parameters in patients with Chiari I malformation is no longer sufficient; instead, more elaborate techniques to analyze foramen magnum CSF flow have become necessary.
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Journal of neurosurgery · Nov 2004
Treatment of trigeminal neuralgia with linear accelerator radiosurgery: initial results.
Radiosurgery has emerged as an important treatment of trigeminal neuralgia. Substantial advantages have been demonstrated in safety and comfort over other modalities. Radiosurgical treatment of trigeminal neuralgia has been well investigated with gamma knife devices involving fixed cobalt sources. Few reports exist concerning trigeminal neuralgia treated using linear accelerator (LINAC)-based devices. In recent years these devices have reached the level of mechanical precision that is required for such functional treatments. The authors describe their initial experience with radiosurgical treatment of trigeminal neuralgia when using a BrainLAB Novalis LINAC device equipped with the commercially available 4-mm collimator. ⋯ High-precision imaging and LINAC instrumentation have allowed for treatment of trigeminal neuralgia with results and safety comparable to those achieved using GKS. Linear accelerator-based radiosurgery with the Novalis device is a safe and effective method of managing trigeminal neuralgia and may become the preferred means at centers where the technology is available.