Neurosurgery
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Clinical Trial
Use of a novel absorbable hydrogel for augmentation of dural repair: results of a preliminary clinical study.
To evaluate the safety and performance of a synthetic dural sealant as an adjunct to standard surgical dural repair techniques to prevent cerebrospinal fluid (CSF) leakage. ⋯ The dural sealant, a synthetic absorbable hydrogel, is a useful adjunct to achieve watertight dural closure. Application resulted in 100% closure of intraoperative CSF leaks. There are no evident adverse effects.
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Comparative Study
Sensory and motor interhemispheric integration after section of different portions of the anterior corpus callosum in nonepileptic patients.
We evaluated somatosensory and motor interhemispheric integration in four patients who underwent transection of different portions of the anterior corpus callosum (CC) for removal of an intraventricular cyst. The study goal was to relate their performances to the topographical organization of the CC. ⋯ The specific disconnections deficits observed in this study may provide the surgeon with information regarding the consequences of anterior callosotomy and allow for remedial measures to be implemented if required.
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Comparative Study Clinical Trial
Resorbable polylactic acid interbody spacers with vertebral autograft for anterior cervical discectomy and fusion.
Resorbable polylactic acid spinal implants have recently become commercially available. These spacers carry the advantages of allowing for clear visualization of new bone growth, eliminating the risk of pathogen transmission, and providing for consistent biomechanical quality. However, previously published reports on the use of these spacers have all utilized bone morphogenetic proteins to supplement the fusion. This report describes our early experience with the use of these devices for interbody reconstruction in anterior cervical discectomy with fusion. ⋯ Resorbable polylactic acid interbody spacers are safe and effective for anterior cervical discectomy and fusion. Use of locally harvested vertebral endplate bone packed within the spacer is sufficient to promote fusion in anterior cervical discectomy with fusion.
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Comparative Study Clinical Trial
Facial and cochlear nerve function after surgery of cerebellopontine angle meningiomas.
Meningiomas of the cerebellopontine angle (CPA) share a common location, but their site of dural origin and their relationship to surrounding neurovascular structures of the CPA are variable. The clinical presentation and outcome after surgical resection are different because of the diversity of this tumor entity. We report on a series of 421 patients with CPA meningiomas, with special emphasis on the analysis of the preoperative and postoperative facial and cochlear nerve function in relation to the site of dural attachment and main tumor location in the CPA cistern. ⋯ Although the outcome of facial and cochlear nerve function is different in CPA meningiomas, depending on the topographic classification of these tumors, preservation of the cochlear nerve is possible in every tumor group and should be attempted in every patient with CPA meningioma. It has to be kept in mind that recovery of hearing was also observed in patients with preoperative profound hearing deficits.
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Comparative Study Clinical Trial
Comparison of conventional region of interest and statistical mapping method in brain single-photon emission computed tomography for prediction of hyperperfusion after carotid endarterectomy.
Hyperperfusion after carotid endarterectomy (CEA) has been proposed as the main mechanism of intracerebral hemorrhage, which is a disastrous complication. The aim of this study was to compare the predictive value of cerebral blood flow (CBF) abnormalities for hyperperfusion after CEA with the conventional region of interest (ROI) analysis and statistical brain mapping analysis. ⋯ Objective assessment of CBF status, especially baseline CBF reduction (z-score), with automatic quantification by 3-D-SSP with normalization had a higher diagnostic value than conventional ROI analysis to identify patients at risk for hyperperfusion after CEA.