Journal of neurosurgery
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Journal of neurosurgery · Apr 2008
Blood blister-like aneurysms of the internal carotid artery trunk causing subarachnoid hemorrhage: treatment and outcome.
The object of this study was to evaluate cases of subarachnoid hemorrhage (SAH) from ruptured blood blister-like aneurysms (BBAs) of the internal carotid artery (ICA) trunk. ⋯ Internal carotid BBAs are rare, small, and difficult to treat endovascularly, with only 2 of 14 patients successfully treated with coil placement. The BBAs rupture easily during surgery (ruptured in 6 of 11 surgical cases). Intraoperative aneurysm rupture invariably led to ICA trap ligation. Sacrifice of the ICA within 48 hours of an SAH led to very poor outcome, even in patients with adequate collateral capacity on preoperative angiograms, probably because of vasospasm-induced compromise of the cerebral collaterals.
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Journal of neurosurgery · Apr 2008
Historical ArticleHonoring the 75th anniversary of the American Association of Neurological Surgeons. Preface.
Ever since the Journal of Neurosurgery (JNS) published its first volume in 1944, the journal has reflected the scientific, technical, and clinical evolution of our specialty and parent organization, first called the Harvey Cushing Society and later the American Association of Neurological Surgeons. The JNS has been an uncompromising arbiter of progress in our specialty, and its superb editorial stewardship has led to its recognition as the premier journal in the field. ⋯ We hope you will enjoy these articles and the accompanying commentaries. In this issue we present the next paper in this series.
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Journal of neurosurgery · Apr 2008
Randomized Controlled TrialEfficacy of motor cortex stimulation in the treatment of neuropathic pain: a randomized double-blind trial.
In this study the authors used a double-blind protocol to assess the efficacy of motor cortex stimulation (MCS) for treating neuropathic pain. ⋯ Motor cortex stimulation is an efficient treatment for neuropathic pain, according to an evaluation facilitated by a double-blind maneuver. Subacute stimulation trials are recommended to determine the optimum motor cortex area to be stimulated and to identify nonresponders.
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Journal of neurosurgery · Apr 2008
Outpatient brain tumor surgery: innovation in surgical neurooncology.
Recent studies of conventional craniotomies and image-guided biopsies have afforded a solid characterization of surgical morbidity and the timing of its occurrence. This report outlines a novel 11-year experience with outpatient image-guided biopsy and outpatient craniotomy for supratentorial intraaxial brain tumors. ⋯ Outpatient image-guided brain biopsy and outpatient craniotomy for tumor resection are safe and effective procedures in selected patients.
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Journal of neurosurgery · Apr 2008
Case ReportsExpanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum.
Craniopharyngiomas are notoriously difficult to treat. Surgeons must weigh the risks of aggressive resection against the long-term challenges of recurrence. Because of their parasellar location, often extending well beyond the sella, these tumors challenge vision and pituitary and hypothalamic function. New techniques are needed to improve outcomes in patients with these tumors while decreasing treatment morbidity. An endoscopic expanded endonasal approach (EEA) is one such technique that warrants understanding and evaluation. The authors explain the techniques and approach used for the endoscopic endonasal resection of suprasellar craniopharyngiomas and introduce a tumor classification scheme. ⋯ The endoscopic EEA requires a thorough understanding of both sinus and skull base anatomy. Moreover, in its application for craniopharyngiomas, an understanding of tumor growth and extension with respect to the optic chiasm and infundibulum is critical to safely approach the lesion via an endonasal route.