Minim Invas Neurosur
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Minim Invas Neurosur · Oct 2006
Clinical TrialA pterion keyhole approach for the treatment of anterior circulation aneurysms.
The supraorbital keyhole approach is most frequently used in treatment for lesions within the anterior cranial base. However, it has some drawbacks, including cosmetically poor appearance of the scar, forehead deformity, and difficulty in dealing with some kinds of middle cerebral artery (MCA) and internal carotid artery (ICA) aneurysms. Therefore, we have developed a small pterion keyhole approach for an alternative access to treat anterior circulation aneurysms. ⋯ No approach-related complication occurred except that one patient had vasospasm 2 days after the aneurysm clipping. In conclusion, this pterion keyhole approach can achieve the best operative effect for the treatment of intracranial anterior circulation aneurysms in a selective group of patients with several advantages over traditional craniotomy including minor tissue damage, less brain retraction, a superior cosmetic result, and shorter duration of surgery. Moreover, the operative field becomes wider in the deep area, providing sufficient space for microscope-assisted surgery without the need for highly specialized instruments.
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Minim Invas Neurosur · Oct 2006
Comparative Study Clinical TrialComparison between transuncal approach and upper vertebral transcorporeal approach for unilateral cervical radiculopathy - a preliminary report.
The surgical treatments for unilateral cervical radiculopathy have been performed by either the anterior or posterior approach. The anterior approach has usually been used more than the posterior approach. The authors compared the results of newly advanced upper vertebral transcorporeal (UVTC) approach with those of the original transuncal (TU) approach in the anterior approach. ⋯ This comparative study demonstrates that the UVTC approach is a better surgical technique than the TU approach considering the preservation of disc height, spinal stability, length of hospital stay, degree of satisfaction and complications.
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Minim Invas Neurosur · Oct 2006
Clinical utility of multislice computed tomographic angiography for detection of cerebral vasospasm in acute subarachnoid hemorrhage.
Digital subtraction angiography (DSA) has been used as the standard method for detecting cerebral vasospasm after subarachnoid hemorrhage (SAH). Multislice computed tomographic angiography (CTA) is a relatively recent method used for evaluating the vasculature of the intracranial arteries. The purpose of this study was to compare multislice CTA and DSA for the detection and quantification of cerebral vasospasm after SAH, and to analyze the usefulness of multislice CTA. ⋯ Multislice CTA is highly sensitive, specific and accurate in detecting mild and moderate cerebral vasospasm. It is less accurate for detecting no vasospasm and marked vasospasm. Therefore, the authors propose that multislice CTA be considered as a useful tool for the detection and management of intracranial vasospasm after SAH.
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Minim Invas Neurosur · Oct 2006
Case ReportsPosterior endoscopic surgery for lumbar disc herniation with contralateral symptoms - a report of two cases.
We report two cases of lumbar disc herniation with contralateral nerve root involvement, surgically treated with a microendoscopic disectomy system (METRx-MED system). The nerve root of the symptomatic side (contralateral to the side of the disc herniation) had been compressed to the superior facet by herniated disc from the opposite side. ⋯ Excision of the herniated disc and decompression of the non-symptomatic nerve root should be done first, approaching from the disc herniation side. After that, through the same approach, the nerve root of the opposite (symptomatic) side should be decompressed.