Neurosurgery
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Neurosurgical procedures such as proximal brachial plexus repair, scalenotomy, and direct isolation of the proximal vertebral artery require a good working knowledge of the triangle of the vertebral artery. This deep triangle of the neck is bound by the subclavian artery and the anterior scalene and longus cervicis muscles. In addition to the vertebral artery, many important structures are found in this area, such as the ganglionated sympathetic chain and certain cervical spinal nerves. ⋯ The C7 spinal nerve was observed in the triangle of the vertebral artery. In addition, the posterior border of the triangle of the vertebral artery was clearly defined in this study, and the middle scalene muscle could be used as a landmark. These data, coupled with our quantitation of parts and structures within the triangle, may assist neurosurgeons who operate on this area of the neck.
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We introduce the lateral transsulcal approach to asymptomatic trigonal meningiomas. ⋯ The lateral transsulcal approach is applicable for small asymptomatic trigonal meningiomas with an acceptable risk of morbidity, even in the dominant hemisphere.
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We evaluated the effectiveness of gamma knife radiosurgery in the treatment of nonfunctioning pituitary adenomas. ⋯ In this series, radiosurgery had a high tumor growth control rate during the long-term follow-up period. Furthermore, we observed a low morbidity rate, with endocrinopathies and optic neuropathies. This low rate included even patients in whom the tumor compressed or was attached to the optic apparatus. We emphasize the necessity of long-term follow-up to evaluate late complications.
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Case Reports
Coverage of painful peripheral nerve neuromas with vascularized soft tissue: method and results.
Our goals are to describe a method of treating painful peripheral nerve neuromas by means of vascularized tissue coverage, report the results in seven patients, and discuss the indications for this treatment modality. An analysis of pain, functionality of the affected body part, professional activities of the patients, and medications before and after surgery is presented. ⋯ Vascularized soft tissue coverage of painful peripheral nerve neuromas seems to be an effective and attractive, but also complex, method of treatment. This option may be considered and reserved for patients who have already undergone several pain treatment modalities without success.
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As a brief reflection on the development of stereotactic neurosurgery, this article reviews its founding and early history in China.