Neurosurgery
-
Review Case Reports
Trigeminal schwannomas: skull base approaches and operative results in 105 patients.
Trigeminal schwannomas make up 0.8% to 8% of all intracranial schwannomas. ⋯ The present series demonstrates acceptable results using microsurgical treatment to remove trigeminal schwannomas. Pain and diplopia may be relieved after surgery; however, hypesthesia frequently remains or may be worsened by surgery.
-
Knowledge of the individual course of the optic radiations (ORs) is important to avoid postoperative visual deficits. Cadaveric studies of the visual pathways are limited because it has not been possible to separate the OR from neighboring tracts accurately and results may not apply to individual patients. Diffusion tensor imaging studies may be able to demonstrate the relationships between the OR and neighboring fibers in vivo in individual subjects. ⋯ Diffusion tensor imaging tractography provides a practical complementary method to study the OR and the Meyer loop anatomy in vivo with reference to individual 3-dimensional brain anatomy.
-
Comparative Study
Quantitative angiographic comparison with the OSIRIS program between the direct and indirect revascularization modalities in adult moyamoya disease.
Up-to-date, quantitative angiographic measurement of revascularization extent after bypass surgery has not been reported. ⋯ The extent of angiographic revascularization in adult moyamoya disease patients was highest in the SMA with EDAMS group and lowest in the EDAS-only group. In addition, angiographic revascularization extent was well correlated with the change in SPECT.
-
Case Reports
The pipeline flow-diverting stent for exclusion of ruptured intracranial aneurysms with difficult morphologies.
The Pipeline Embolization Device (PED) is a flow-diverting stent that may represent a new therapeutic tool for difficult-to-treat intracranial aneurysms, including those that present with subarachnoid hemorrhage (SAH). ⋯ Endovascular treatment with the pipeline flow-diverting stent may be a viable treatment option for otherwise difficult-to-treat aneurysm morphologies in the context of acute SAH.
-
Comparative Study
Meningioma surgery in the elderly: outcome and validation of 2 proposed grading score systems.
Although population age increases, published evidence on meningioma treatment in the elderly is scarce. ⋯ Meningioma resection in the elderly is possible with some mortality. We were unable to reproduce the utility of 2 proposed grading systems for mortality prediction when extending to younger patients. In single-factor analysis, only concomitant disease and ASA score remained significant. The decision whether to operate should be taken individually. Patients with severe concomitant disease or high ASA score should be advised not to undergo surgical therapy independently from other factors.