Neurosurgery
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The Sophysa Pressio (Sophysa Ltd., Orsay, France) is a new intracranial pressure monitoring system. This study aimed to evaluate its accuracy and compare it with the popular Codman intracranial pressure transducer (Codman/Johnson & Johnson, Raynham, MA) in vitro. ⋯ The new Pressio transducer proved to be accurate for measuring static and dynamic pressure during in vitro evaluation.
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Transnasal endoscopic cranial base surgery is a novel minimal-access method for reaching the midline cranial base. Postoperative cerebrospinal fluid leak remains a persistent challenge. A new method for watertight closure of the anterior cranial base is presented. ⋯ The gasket-seal closure is an effective method for achieving watertight closure of the anterior cranial base after endoscopic intradural surgery.
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The cases of two patients who presented with sylvian aqueductal obstruction caused by venous lesions (an ectatic vein and a developmental venous anomaly, which are uncommon causes of obstructive hydrocephalus) are reported. ⋯ Venous anomalies may cause obstructive hydrocephalus and can be suspected in cases of chronic and intermittent headaches. Endoscopic third ventriculostomy is an effective treatment.
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Radiosurgery can be considered a well-established option for the treatment of arteriovenous malformations (AVMs). The exact application of the therapeutic dose is based on the availability of imaging data sets with superior image quality that can be superimposed using an image fusion algorithm. For follow-up studies, the quantitative comparison of the respective image data sets also plays an important role. Until now, digital subtraction angiography (DSA) has been a mandatory tool for treatment planning and follow-up procedures. The aim of this study was to investigate whether a suitable computed tomographic (CT) and/or magnetic resonance (MR) angiography procedure can replace DSA and, if so, in which cases. ⋯ By integrating all available imaging modalities, the exact three-dimensional definition of the AVM nidus was safely realized for all patients. Stereotactic DSA data acquisition remains a crucial tool for safe nidus definition in radiosurgery treatment planning and cannot, therefore, be discarded at present. It is recommended that a quantitative comparison of all MR follow-up studies be established.
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To describe a variant of the stent-assisted coiling technique in the endovascular treatment of aneurysms with a dome-to-neck ratio less than 1.5. ⋯ We found that the stentjack technique was helpful in the treatment of selective aneurysms with a dome-to-neck ratio smaller than 1.5.