Journal of neurosurgery
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Journal of neurosurgery · Jan 2012
Case ReportsCombined pallidal and subthalamic nucleus stimulation in sporadic dystonia-parkinsonism.
Multifocal deep brain stimulation (DBS) is a new technique that has been introduced recently. A 39-year-old man with dystonia-parkinsonism underwent the simultaneous implantation of subthalamic nucleus (STN) and globus pallidus internus (GPi) DBS electrodes. ⋯ Formal assessment at the 1-year follow-up showed that both the parkinsonian symptoms and the dystonia were markedly improved via continuous bilateral combined STN and GPi stimulation. Sustained benefit was achieved at 3 years postoperatively.
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Journal of neurosurgery · Jan 2012
Stereotactic radiosurgery for arteriovenous malformations, Part 4: management of basal ganglia and thalamus arteriovenous malformations.
The authors conducted a study to define the long-term outcomes and risks of stereotactic radiosurgery (SRS) for arteriovenous malformations (AVMs) of the basal ganglia and thalamus. ⋯ Stereotactic radiosurgery is a gradually effective and relatively safe management option for deep-seated AVMs in the basal ganglia and thalamus. Although hemorrhage after obliteration did not occur in the present series, patients remain at risk during the latency interval between SRS and obliteration. The best candidates for SRS are patients with smaller volume AVMs located in the basal ganglia.
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The authors present the case of a 21-year-old female with a progressive bitemporal hemianopsia. Cranial MR imaging revealed a large cystic suprasellar, retrochiasmatic lesion consistent with craniopharyngioma. ⋯ Each portion of this procedure was recorded and is presented in an edited high-definition format. The video can be found here: http://youtu.be/i3-qieLlbVk.
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Journal of neurosurgery · Jan 2012
Stereotactic radiosurgery for arteriovenous malformations, Part 3: outcome predictors and risks after repeat radiosurgery.
The object of this study was to evaluate the outcomes and risks of repeat stereotactic radiosurgery (SRS) for incompletely obliterated cerebral arteriovenous malformations (AVMs). ⋯ Repeat SRS for incompletely obliterated AVMs increases the eventual obliteration rate. Hemorrhage after obliteration did not occur in this series. The best results for patients with incompletely obliterated AVMs were seen in patients with a smaller residual nidus volume and no prior hemorrhages.
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Journal of neurosurgery · Jan 2012
Modified one-piece extended transbasal approach for resection of giant anterior skull base sinonasal teratocarcinosarcoma.
The transbasal approach is considered the workhorse for removing a variety of benign and malignant tumors of the anterior skull base. In some instances, removal of the supraorbital bar in addition to a standard bifrontal craniotomy (extended transbasal approach) allows for additional basal exposure, thereby minimizing brain retraction. In this operative video atlas report, the authors describe and demonstrate a modified one-piece extended transbasal craniotomy that incorporates the anterior wall of the frontal sinus. ⋯ Removal of a giant anterior skull base sinonasal teratocarcinosarcoma via the modified one-piece extended transbasal approach is demonstrated in this operative video atlas. The authors describe and illustrate the operative nuances and surgical pearls to safely and efficiently perform the approach, tumor resection, and multilayered reconstruction of the cranial base defect. The video can be found here: http://youtu.be/x1lTtfqKIV0.