Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
-
Case Reports
Role of arterioles in management of microvascular decompression in patients with hemifacial spasm.
Although microvascular decompression (MVD) is accepted as an effective therapy for hemifacial spasm (HFS), some operations fail. While performing MVD, many surgeons focus on the large arteries but ignore the arterioles. Failure to identify involved arterioles may account for unsuccessful MVD. ⋯ After surgery, spasms ceased in all patients and no recurrence was found up to the one-year follow-up. To achieve a positive post-operative outcome, exploration of the entire CN VII is necessary, with a focus on the small arterioles. AMR can be a good adjuvant to identify the involved arterioles.
-
Non-functioning pituitary adenomas are primarily a surgically managed pathology, but recurrence or regrowth is not uncommon. Previous large series have retrospectively validated the use of the Gamma Knife (GK) as an adjuvant treatment. To our knowledge, we present the largest case series to date with the Linear Accelerator (Linac) for the management of this pathology. ⋯ The local control rates at 5 years for SRS, FRST and CRT were 100%, 93% and 87% respectively. Treatment-related morbidity was low. These data confirm that Linac SRS and FSRT are safe and effective for the treatment of non-functioning pituitary adenomas.