Neurosurgery
-
Deterioration in hearing after Gamma Knife radiosurgery of vestibular schwannomas is a well-documented risk. Recent studies suggest a correlation between cochlear radiation dose and hearing preservation. ⋯ Older patients are more vulnerable to detrimental effects of Gamma Knife radiosurgery on hearing. We propose that cochlear dose volume histograms be created and used to reduce the percentage of the cochlear volume exposed to radiation doses greater than 5.3 Gy. This is the first report to suggest that the conformity index tumor coverage may be an important predictor of hearing outcomes.
-
The incidence of traumatic craniocervical artery dissection varies in published trauma series. ⋯ Whole-body trauma computed tomography with an adapted scanning protocol for the craniocervical vessels is a fast, safe, and feasible method for detecting vascular injuries. It allows prompt further treatment if necessary. Computed tomography angiography could be a part of a broad screening protocol for craniocervical vessels in documented injuries of the head and neck and in trauma mechanisms influencing the craniocervical region as well.
-
Case Reports
Successful anterior capsulotomy in comorbid anorexia nervosa and obsessive-compulsive disorder: case report.
State-of-the-art treatment of anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) often proves ineffective. Both disorders have common features, and anterior capsulotomy is a last-resort treatment for OCD. We document the effect of bilateral anterior capsulotomy in a patient with comorbid AN and OCD. ⋯ This case report suggests that bilateral anterior capsulotomy can be a therapeutic option for patients with comorbid AN and OCD. However, a well-controlled study is warranted.
-
Successful management of pediatric arteriovenous malformations (AVMs) often requires a balanced application of embolization, surgery, and radiosurgery. ⋯ Treatment of pediatric AVMs with multimodality therapy can substantially improve obliteration rates and may decrease AVM hemorrhage rates. The poor natural history and risks of intervention must be carefully considered when deciding to treat high-grade pediatric AVMs.
-
In cases of large and giant vestibular schwannomas (VS), the visualization of the internal auditory canal (IAC) opening is difficult or impossible. ⋯ The Tübingen line is an easy, consistent, and safe method to locate the projection of the IAC along the posterior surface of the temporal bone.