Journal of neurosurgery
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Journal of neurosurgery · Sep 2012
Interactive virtual simulation using a 3D computer graphics model for microvascular decompression surgery.
The purpose of this paper is to report on the authors' advanced presurgical interactive virtual simulation technique using a 3D computer graphics model for microvascular decompression (MVD) surgery. ⋯ Our interactive virtual simulation using a 3D computer graphics model provided a realistic environment for performing virtual simulations prior to MVD surgery and enabled us to ascertain complex microsurgical anatomy.
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Journal of neurosurgery · Sep 2012
Biography Historical ArticleLeo Max Davidoff: his formative years and participation in the MacMillan Arctic Expedition.
Leo Max Davidoff was one of the outstanding students of Harvey Cushing, who helped create the discipline of modern neurological surgery. In his own right, Dr. ⋯ He also helped to found the Albert Einstein College of Medicine of Yeshiva University. This paper describes his early life and education, together with his participation in the MacMillan Arctic Expedition of 1925.
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Journal of neurosurgery · Sep 2012
Review Meta AnalysisDecompressive craniectomy: a meta-analysis of influences on intracranial pressure and cerebral perfusion pressure in the treatment of traumatic brain injury.
In recent years, the role of decompressive craniectomy for the treatment of traumatic brain injury (TBI) in patients with refractory intracranial hypertension has been the subject of several studies. The purpose of this review was to evaluate the contribution of decompressive craniectomy in reducing intracranial pressure (ICP) and increasing cerebral perfusion pressure (CPP) in these patients. ⋯ Decompressive craniectomy can effectively decrease ICP and increase CPP in patients with TBI and refractory elevated ICP. Further studies are necessary to define the group of patients that can benefit most from this procedure.
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Journal of neurosurgery · Sep 2012
Review Case ReportsIntracranial hypotension producing reversible coma: a systematic review, including three new cases.
Intracranial hypotension is a disorder of CSF hypovolemia due to iatrogenic or spontaneous spinal CSF leakage. Rarely, positional headaches may progress to coma, with frequent misdiagnosis. The authors review reported cases of verified intracranial hypotension-associated coma, including 3 previously unpublished cases, totaling 29. ⋯ The literature review revealed that numerous additional patients with clinical histories consistent with intracranial hypotension but no radiological confirmation developed SDH following a spinal procedure. Several such patients experienced poor outcomes, and there were multiple deaths. To facilitate recognition of this treatable but potentially life-threatening condition, the authors propose criteria that should prompt intracranial hypotension workup in the comatose patient and present a stepwise management algorithm to guide the appropriate diagnosis and treatment of these patients.
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Journal of neurosurgery · Sep 2012
Review Case ReportsTwo-handed endoscopic-directed vestibular nerve sectioning: case series and review of the literature.
Vestibular nerve sectioning is an accepted surgical treatment option for patients with medically refractory Ménière disease. In this paper the authors introduce and evaluate a 2-handed endoscopic-directed technique for vestibular nerve section. ⋯ The endoscopic-directed approach represents a safe and effective method for performing vestibular nerve sectioning. Until now, the endoscope has been used primarily as an adjunct to the operating microscope in surgery at the cerebellopontine angle. In addition, previous endoscopic techniques typically require a third hand to manipulate the endoscope. With the 2-handed endoscopic-directed technique, however, the endoscope is used as the primary means of visualization, and the unique design of this endoscope allows for a bimanual procedure without the requirement of a cosurgeon. Advantages of using this technique compared with the microscope include superior brightness at close distances, greater depth of field, increased maneuverability within small regions, and an improved ability to visualize objects not in a direct line of sight. Among other things, this allows for minimally invasive openings, decreased cerebellar retraction, and better identification of nerve cleavage planes and vascular anatomy.