Minim Invas Neurosur
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Minim Invas Neurosur · Dec 2008
Frameless stereotactic radiosurgery with a bite-plate: our experience with brain metastases.
Non-invasive frameless stereotactic radiosurgical systems have recently been developed. We report our experience of frameless stereotactic radiosurgery (SRS) with a bite-plate for brain metastases. Between February 2002 and December 2005, 147 patients with brain metastases were treated with C-arm linear accelerator-based SRS and 122 patients were followed up by our institute. ⋯ Nine patients who had brain metastases in or close to the brain stem were treated with fractionated stereotactic radiotherapy. The frameless stereotactic radiosurgical system with a bite-plate is safe and effective for the treatment of brain metastasis. Elderly male patients sometimes are edentulous and require placement of a head ring for radiosurgery.
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Minim Invas Neurosur · Dec 2008
Case ReportsTentorial incision in a lateral-medial direction with minimal retraction of the temporal lobe in the subtemporal transtentorial approach to the middle tentorial incisural space.
The subtemporal transtentorial approach provides excellent exposure of the middle incisural space. A modification of the subtemporal transtentorial approach with use of a partial mastoidectomy is presented to avoid damage to the temporal lobe as a result of retraction as well as damage to venous structures. ⋯ Although additional partial mastoidectomy is time-consuming, it reduces the risk of damage to the temporal lobe as a result of retraction as well as damage to venous structures.
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Minim Invas Neurosur · Dec 2008
Case ReportsNeuroendoscopic removal of intraventricular hemorrhage combined with hydrocephalus.
The neuroendoscope is playing an increasing role in the diagnosis and treatment of several types of lesions, in particular in the ventricular system. Hydrocephalus associated with intraventricular hemorrhage (IVH) is a good indication for neuroendoscopic surgery. We describe herein our experiences with 17 cases of IVH combined with hydrocephalus treated using a neuroendoscope. ⋯ Neuroendoscopic procedures with a flexible fiberscope for the removal of IVH allow resolution of the disturbed CSF circulation. This procedure improves the safety and accuracy of treatment for IVH combined with hydrocephalus.
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Minim Invas Neurosur · Dec 2008
The use of the Olympus EndoArm for spinal and skull-based transsphenoidal neurosurgery.
Minimally invasive surgical techniques have evolved to reduce soft-tissue injury associated with open surgical techniques. The use of endoscopic visualization allows the exposure of deep structures and provides a mechanism to perform all the components of an open surgical procedure through small portals, thus satisfying a basic requirement of minimally invasive surgical procedures. Surgeons in the field of skull-base and spine surgery are now taking advantage of the benefits of such endoscopes. ⋯ These cases include minimally invasive cervical and lumbar decompression procedures, as well as more recently the resection of larger and more extensive pituitary tumors. In this paper, the multiple advantages of the Olympus EndoArm endoscopic holder are described in detail. As more surgeons gain experience with endoscopes in skull-base surgery, the hope is that operative times will be shorter and more extensive surgical resections will be possible with less patient morbidity.
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Minim Invas Neurosur · Dec 2008
Case ReportsTumor resection utilizing a minimally invasive spinal retractor with a novel cranial adaptor.
This article describes a method of performing an intracerebral tumor resection utilizing a novel dilator attachment with a system designed for minimally invasive spinal surgery. ⋯ Tumor resection can safely be accomplished using a minimally invasive spine retractor system with a novel dilator adapted for the system. This reduces the size of the cortisectomy and therefore reduces the risk of post-operative neurological damage while still allowing ample room for adequate tumor resection.