Minim Invas Neurosur
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Minim Invas Neurosur · Jun 2008
Low-dose gamma knife radiosurgery for cavernous sinus hemangioma: report of 3 cases and literature review.
Optimal management of cavernous sinus hemangiomas remains unclear. Total microsurgical removal of these neoplasms may be extremely difficult due to their rich vascularization. Three cases of cavernous sinus hemangioma treated with low-dose Gamma Knife radiosurgery are presented. ⋯ In all patients the shrinkage of the neoplasm was accompanied by notable improvement of the preexistent oculomotor nerve palsy. No radiosurgery-related complications were met during follow-up. In conclusion, low-dose Gamma Knife radiosurgery seems to be very effective for management of cavernous sinus hemangiomas, and can be considered as a treatment modality of choice for these lesions.
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Minim Invas Neurosur · Jun 2008
Modified vertebroplasty using a curved probe: technique and preliminary results.
One of the main limitations of vertebroplasty is the excessive pressure required for injection of sufficient cement into a vertebral body. Kyphoplasty can be used to reduce injection pressure by making a void with a balloon tamp. The author presents a technique of making small voids to reduce cement delivery pressure during vertebroplasty that involves a simple modification of the conventional technique. ⋯ The described modification of vertebroplasty involving the creation of small cavities using a curved probe appears to control cement injection easily during the procedures and minimize cement leakage-related complications.
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Minim Invas Neurosur · Jun 2008
Case ReportsMinimally invasive surgical closure of a spinal dural arteriovenous fistula.
The treatment of a spinal dural arteriovenous fistula (DAVF) via a minimally invasive approach utilizing a tubular retraction system is described. ⋯ Surgical treatment of spinal DAVFs can be performed in a targeted, minimally invasive manner with a short operative time and minimal tissue disruption.
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Minim Invas Neurosur · Jun 2008
The Miethke dual switch valve: experience in 169 adult patients with different kinds of hydrocephalus: an open field study.
In spite of the development of approximately 200 different shunt systems within the last 50 years, overdrainage and valve obstructions are still major problems in the current treatment of hydrocephalus. In 1994, a new gravitational valve with different opening pressures (depending upon the patient's posture) and a big contact area to CSF was introduced by Miethke and co-workers (DSV). We report about a single institution's experience in the treatment of 169 adult patients with different kinds of hydrocephalus with this valve. ⋯ Among the currently available shunt systems, this series is one with the lowest complication rates due to overdrainage and valve obstructions. In patients with NPH, where low opening pressures are essential, the DSV seems to bear an advantage because of a high drainage rate and, in spite of this, a low rate of overdrainage. Even in patients with relatively high CSF protein content, we did not observe any valve obstruction. This study was an open field analysis providing data about the current complication rates of hydrocephalus treatment with this shunt system, outside of a specialized hydrocephalus team or a prospective study trial. However, this study is a retrospective analysis and a prospective randomized controlled trial is required for the comparison of these valves with other shunt systems, such as programmable and flow-controlled ones is required for the future.