Neurosurgery
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Clinical Trial
Cranial nerve preservation and outcomes after stereotactic radiosurgery for jugular foramen schwannomas.
Jugular foramen region schwannomas are rare intracranial tumors that usually present with multiple lower cranial nerve deficits. For some patients, complete surgical resection is possible but may be associated with significant morbidity. Stereotactic radiosurgery is a minimally invasive alternative or adjunct to microsurgery for such tumors. We reviewed our clinical and imaging outcomes after patients underwent gamma knife radiosurgery for management of jugular foramen schwannomas. ⋯ Stereotactic radiosurgery proved to be a safe and effective management for newly diagnosed or residual jugular foramen schwannomas. Long-term tumor control rates and stability or improvement in cranial nerve function was confirmed.
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Safe and beneficial surgery of the human cerebrum is arguably one of mankind's most notable achievements and one of the great testimonials to human creativity, intelligence, and character. In many ways, it is a testimony to the climates of civilization that have marked human history. In historical terms, in the year 2007, cranial surgery celebrated its 12,000th birthday, with cranial manipulation for various religious, mystical, and therapeutic reasons being evident in Africa more than 10 millennia before the birth of Christ. ⋯ It is in fact a 12,000 year prelude to the modernity that we currently enjoy. Before attempting to define our modernity and emerging futurism with reinvention, examination of the prolonged and tedious invention is appropriate for perspective. The following examines and recounts the accrual of data and changes in attitude over the stream of history that have allowed refined surgery of the human cerebrum to become a reality.
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We studied the effect of hypothermia on intracranial pressure, systemic and intracranial hemodynamics, and metabolism in patients with severe traumatic brain injury to clarify the optimal temperature for hypothermia, with a view toward establishing the proper management techniques for such patients. ⋯ These results suggest that, after traumatic brain injury, decreasing body temperature to 35 to 35.5 degrees C can reduce intracranial hypertension while maintaining sufficient cerebral perfusion pressure without cardiac dysfunction or oxygen debt. Thus, 35 to 35.5 degrees C seems to be the optimal temperature at which to treat patients with severe traumatic brain injury.