Neurosurgical review
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Neurosurgical review · Oct 2012
Case Reports Comparative StudyBilateral middle cerebral artery aneurysms: a comparative study of unilateral and bilateral approaches.
The best surgical method for the treatment of patients with bilateral middle cerebral artery (bMCA) aneurysms has not been fully determined yet. The main purpose of this study is to compare the surgical results of unilateral and bilateral approaches to bMCA aneurysms including mean operation time, mean hospital stay, and mean cost, in the experience of the same neurosurgical team. Between January 2001 and June 2010, 22 patients with bMCA aneurysms were surgically treated in our institution. ⋯ The results of surgery for both approaches are almost the same. However, the unilateral approach has certain advantages compared to the bilateral approach. Therefore, the unilateral approach may be a good alternative in surgical management of patients with bMCA aneurysms in selected cases and the abovementioned parameters can help the neurosurgeon in patient selection.
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Neurosurgical review · Oct 2012
Case ReportsEpidural anterior petrosectomy with subdural visualization of sphenobasal vein via the anterior transpetrosal approach--technical case report.
The drainage of the superficial middle cerebral vein (SMCV) is classified into four subtypes. The sphenobasal vein (SBV) drains from the SMCV to the pterygoid venous plexus at the temporal skull base. Epidural procedures in the standard anterior transpetrosal approach (ATPA) may damage the route of the SBV. ⋯ The tumor compressed the root exit zone of the trigeminal nerve. The tumor was grossly totally removed. The modified ATPA (epidural anterior petrosectomy with subdural visualization of the SBV) is effective in preserving the SBV.
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Neurosurgical review · Oct 2012
Preauricular transzygomatic anterior infratemporal fossa approach for tumors in or around infratemporal fossa lesions.
Various surgical approaches to the infratemporal fossa (ITF) have been reported. Among them, the preauricular transzygomatic anterior ITF approach (anterior ITF approach) has been used for exposure of the antero-superior part of the ITF. The purpose of this article is to show anatomical dissections using the anterior ITF approach and to evaluate our surgical experience using this approach. ⋯ Gross total removal was achieved in 27 of the 31 patients. No mortality or severe morbidity was encountered. Therefore, the anterior ITF approach provides easy access to the ITF and adjacent regions without destruction of important organs.
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Neurosurgical review · Jul 2012
Neuroendoscopic management of posterior third ventricle and pineal region tumors: technique, limitation, and possible complication avoidance.
The endoscopic approach has gained an increased popularity in recent years for the biopsy and, in selected cases, the removal of tumors of the posterior third ventricle and pineal region. The authors report their experience on a series of 20 patients discussing also the technical limitations and complication avoidance. This is a prospective study of 20 patients with posterior third ventricle and pineal region tumors surgically managed by endoscopic biopsy and/or excision and simultaneous third ventriculostomy. ⋯ Higher rate of complications was found in the case of vascularized and/or larger lesions. Endoscopic management of posterior third ventricle lesions may represent an effective option. However, though biopsies remain often a safe procedure, tumor excision should be limited to highly selected cases (cystic, poorly vascularized, and/or smaller than 2.5-cm lesions).
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Neurosurgical review · Jul 2012
Randomized Controlled TrialEffect of magnesium sulfate therapy on patients with aneurysmal subarachnoid hemorrhage using serum S100B protein as a prognostic marker.
Magnesium, one of the essential trace elements, plays important roles in maintaining both normal cellular and body functions. S100 calcium-binding protein B (S100B) has been used as a marker of glial damage in several neurological disorders. Thirty patients with ruptured intracranial aneurysms treated by clipping are included. ⋯ There is no statistically significant difference between both groups as regards outcome at 3 months using clinical status and S100B values. There is a tendency in the magnesium group to have better outcomes. Further studies with more number of patients with subarachnoid hemorrhage are needed to determinate the accuracy of S100B protein as a prognostic marker and of magnesium sulfate as a neuroprotector.