Neurosurgery
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Comparative Study
Comparison of magnetic tracking and optical tracking by simultaneous use of two independent frameless stereotactic systems.
The goal of this study was to compare the calculated accuracy and the true surgical accuracy of a magnetic and an optical tracking system at surgical registration and during surgery. ⋯ Magnetic referencing and tracking was found to be comparable with optical tracking both with regard to calculated and true surgical accuracy. Interference from metal objects in the magnetic field was seen rarely.
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Comparative Study Clinical Trial
Neuroendoscopic aspiration of hematocephalus totalis: technical note.
Massive intraventricular hemorrhage requires aggressive and rapid management to decrease intracranial hypertension. The amount of intraventricular blood is a strong prognostic predictor, and its fast removal is a priority. Neuroendoscopy may offer some advantages over more traditional surgical approaches. We describe here the technical details and clinical outcomes of the neuroendoscopic management of massive tetraventricular hemorrhage in 25 consecutive patients, highlighting the potential pitfalls and the advantages of the technique. ⋯ Intraventricular hemorrhage, analogously to other ventricular diseases, can be treated successfully with flexible endoscopes. Obviously, the limitation of this study lies in its observational nature; however, the encouraging results reported here should prompt a randomized study to evaluate the effectiveness and efficiency of the endoscopic approach in comparison to the more established semiconservative management offered by external derivation with fibrinolytic agents.
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Comparative Study
Techniques for aspirating bone marrow for use in spinal surgery.
The osteogenicity of bone marrow has been well documented in the literature. The use of bone marrow as a source of osteoprogenitor cells for spinal fusion surgery is increasing. Improper aspiration technique can lead to dilution of bone marrow and a subsequent reduction in osteoprogenitor cells. Therefore, correct aspiration technique is imperative to the successful use of bone marrow with various grafting combinations. ⋯ Clinical studies currently under way will answer the question of bone marrow efficacy in spinal fusion surgery.
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Comparative Study
Surgical technique to retract the tentorial edge during subtemporal approach: technical note.
To describe a surgical technique to retract the tentorial edge during the subtemporal approach initially introduced and used widely by Drake and Peerless to treat distal basilar artery aneurysms. ⋯ We inserted a small straight microclip with one arm through the incision on the surface of the floor of the middle fossa and the other at the free margin of the tentorial edge as a fast and simple method of retracting the tentorial edge during a subtemporal approach.
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Comparative Study
Adjuvant gamma knife stereotactic radiosurgery at the time of tumor progression potentially improves survival for patients with glioblastoma multiforme.
Gamma knife stereotactic radiosurgery (GK-SRS) is a safe and noninvasive treatment used as adjuvant therapy for patients with glioblastoma multiforme (GBM). Several studies have yielded conflicting results in the effectiveness of radiosurgery in GBM. This study is a retrospective review of our institutional experience with GK-SRS adjuvant therapy in the treatment of GBM. ⋯ GK-SRS is a relatively safe and noninvasive procedure that conferred an improvement in overall survival of GBM patients in our retrospective study. Particularly, GK-SRS may improve overall survival when performed at the time of tumor progression.