Neurosurgery clinics of North America
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Neurosurg. Clin. N. Am. · Jul 2000
Treatment of chronic subdural hematoma by burr holes and closed-system drainage.
This article highlights the treatment of choice of chronic subdural hematoma. The importance, effectiveness, and low complication rate of minimally invasive procedure by burr holes and closed-system drainage is discussed.
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Neurosurg. Clin. N. Am. · Apr 2000
ReviewSurgical treatment of nonatherosclerotic lesions of the extracranial carotid artery.
Nonatherosclerotic disorders of the extracranial carotid artery, such as dissections, aneurysms, and carotid body tumors, are diverse in their causes, presentations, and modes of treatment. The surgical treatment of these lesions often will require a higher exposure of the extracranial carotid than is typical for a carotid endarterectomy. The prevention of perioperative ischemic injury assumes a major role in determining the surgical strategy for treating these lesions. This article offers a brief description of several of these disorders, a review of the general surgical approach to the high cervical artery, and a brief description of lesion-specific surgical techniques.
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The accurate diagnosis of acute ischemic stroke is possible using clinical skills and diagnostic tools that are familiar to all neurosurgeons. Avoidance of immediate complications relies on the fundamentals of critical care. ⋯ Surgical treatment in a small number of ischemic stroke patients can be lifesaving and may afford reasonable functional recovery. This article discusses typical clinical presentations and differential diagnosis, diagnostic imaging for ischemic stroke, and possible treatments.
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The author has had considerable experience with the use of general anesthesia and regional anesthesia for patients undergoing carotid endarterectomy. His experience and a review of the literature indicate that the use of regional anesthesia significantly reduces the incidence of nonsurgical complications following operation. A particularly robust effect is placed on reducing cardiopulmonary complications.
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Neurosurg. Clin. N. Am. · Jan 2000
ReviewEndovascular management of patients with cerebral arteriovenous malformations.
The endovascular management of brain arteriovenous malformations (AVMs) is a part of the therapeutic AVM strategy. In selected cases, endovascular therapy may lead to a total and permanent cure, but in most cases it will be an adjunctive therapy to microsurgery or radiosurgery. Embolization of brain AVMs is still a technical challenge that requires experience and skill on the part of the physician and requires a further improvement of tools, but it has made brain AVMs curable.