Neurosurgery
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Comparative Study Clinical Trial
Tumors of the lateral and third ventricle: removal under endoscope-assisted keyhole conditions.
Intraventricular tumors usually are managed by approaches and microsurgical techniques that need retraction and dissection of important brain structures. Minimally invasive endoscopic procedures achieve a remarkable alternative to conventional microneurosurgical techniques. Endoscope-assisted microneurosurgery may be a minimally invasive technique with maximally effective treatment. Using the keyhole concept for planning the surgical strategy, the reduction of the brain retraction is achieved, which is one of the main benefits of this technique. ⋯ Endoscope-assisted keyhole neurosurgery seems to be a safe method of removing tumors in all regions inside the ventricular system with a low risk of permanent neurological deficits. The exact surgical corridor planning on the basis of the keyhole strategy offers less traumatic exposure of even deep-seated endoventricular tumors.
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Comparative Study Clinical Trial
Microendoscopic discectomy compared with standard microsurgical discectomy for treatment of uncontained or large contained disc herniations.
Minimally invasive spinal techniques have been developed for years in an attempt to minimize trauma. However, most endoscopic techniques have been unable to address uncontained or large contained disc herniations. The aim of this prospective study was to compare the results of microendoscopic discectomy (MED) and microsurgical discectomy in the treatment of patients with uncontained or large contained disc herniations. ⋯ MED is at least as effective as microsurgical discectomy for treatment of uncontained or large contained disc herniations, although the advantages over the open technique are short lived and did not reach significance. Nonetheless, for the surgeon accustomed to endoscopic techniques, MED seems to be a safe procedure.
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In strictly selected cases of middle cerebral artery (MCA) occlusion, revascularization by extracranial-intracranial (EC-IC) bypass can be considered. The interventional recanalization of the occlusion under direct surgical control has not been reported in the literature so far. ⋯ On the basis of our experience, in nonatherosclerotic occlusions, intravascular intervention may be considered.
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Comparative Study
Stereoelectroencephalography in the presurgical evaluation of focal epilepsy: a retrospective analysis of 215 procedures.
To report on indications, surgical technique, results, and morbidity of stereoelectroencephalography (SEEG) in the presurgical evaluation of patients with drug-resistant focal epilepsy. ⋯ SEEG is a useful and relatively safe tool in the evaluation of surgical candidates when noninvasive investigations fail to localize the epileptogenic zone. SEEG-based resective surgery may provide excellent results in particularly complex drug-resistant epilepsies.
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Comparative Study
Association between recurrent concussion and late-life cognitive impairment in retired professional football players.
Cerebral concussion is common in collision sports such as football, yet the chronic neurological effects of recurrent concussion are not well understood. The purpose of our study was to investigate the association between previous head injury and the likelihood of developing mild cognitive impairment (MCI) and Alzheimer's disease in a unique group of retired professional football players with previous head injury exposure. ⋯ Our findings suggest that the onset of dementia-related syndromes may be initiated by repetitive cerebral concussions in professional football players.