Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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To evaluate the outcome and complications of spinal cord stimulation (SCS) for chronic neuropathic pain in an Australian population. ⋯ SCS is an effective treatment in the control of chronic neuropathic pain, particularly in combination with comprehensive medical management within a multidisciplinary pain management centre.
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To define the clinical characteristics of cystic acoustic neuroma, we retrospectively analyzed 22 patients with cystic acoustic neuroma and reviewed the literature with regard to clinical manifestation, imaging features, diagnosis, surgical procedures and prognosis. An acoustic neuroma was defined as cystic according to the following criteria: the presence of hypodense/hypointense areas on CT or MRI, the identification of cystic elements at operation and histological verification. ⋯ Complete removal of the tumor was achieved in 18 cases (81.8%). We conclude that patients with cystic acoustic neuroma need prompt surgery with special attention paid to the preservation of the facial nerve.
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A 50-year-old woman first presented with recurrent craniopharyngioma in the suprasellar region. The recurrent tumor was removed via the frontobasal interhemispheric approach. ⋯ Histological examination showed the left frontal lesion was an ectopic recurrence of craniopharyngioma. Ectopic recurrence of craniopharyngioma is extremely rare.
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To probe the feasibility and utility of neuroendoscopic inspection of the anatomy of the cerebellopontine angle (CPA) and of neuroendoscopic assisted microneurosurgery (NEAMN) for CPA lesions via a retrosigmoid approach, we used retrosigmoid NEAMN in 28 patients with CPA lesions. Prior to this, we undertook anatomical observation of bilateral CPA in two adult cadaver heads using the neuroendoscope. NEAMN tumour resection was performed in eight acoustic neuromas, one meningioma and 14 cholesteatomas and NEAMN vascular decompression was performed in five patients with trigeminal neuralgia. ⋯ The CPA can be divided into three levels - the cranial, medial, and caudal, and each level contains specific neurovascular structures as seen through the neuroendoscope. Knowledge of these divisions is useful to master the common NEAMN procedures of the CPA. NEAMN for CPA lesions via a retrosigmoid approach is a useful adjunct to standard microneurosurgical techniques effect and may decrease the operative risk.
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A number of different techniques are used to treat chronic subdural hematomas surgically. In this study, 70 chronic subdural hematomas were surgically treated and analyzed prospectively. Patients were classified according to clinical features and computed tomography images. ⋯ Recurrence rates were 17% in group A and 14% in group B. No significant difference was noted in terms of hospitalization duration or postoperative complications. In conclusion, we believe that the burr-hole craniostomy-irrigation technique is a reliable and effective method compared to burr-hole craniostomy-closed system drainage in the treatment of chronic subdural hematoma.