Minim Invas Neurosur
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Minim Invas Neurosur · Oct 2007
Neuronavigation and resection of lesions located in eloquent brain areas under local anesthesia and neuropsychological-neurophysiological monitoring.
The aim of this study was to determine the safety and maximal extension of tumor resection achievable with a combination of awake craniotomy under local anesthesia, neuronavigation, and continuous neuropsychological and neurophysiological monitoring in patients with lesions within the eloquent brain. ⋯ The combination of neuronavigation with cortical stimulation and repetitive neurological and language examinations allows a more radical resection of tumors in eloquent brain areas, otherwise considered as inoperable.
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Minim Invas Neurosur · Oct 2007
A simple technique for bridging small cranial dural defects without the use of grafts: technical note.
A watertight closure of the dura is important in preventing post-operative complications. Various techniques are described to close small dura defects. We present a simple technique that uses on site homologues dura tissue to bridge small dura defects by separating the periosteum from the inner meningeal layer. This provides a low-cost, tension-free repair without the use of synthetic materials or need to harvest autologous materials.
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Minim Invas Neurosur · Aug 2007
Case ReportsUse of 3DFT-CISS sequences and virtual MR endoscopy for the neuroendoscopic treatment of unilateral hydrocephalus: case illustration.
Intraventricular virtual MR endoscopic imaging of the foramen of Monro region by using three-dimensional Fourier transformation constructive interference in steady state (3DFT-CISS) magnetic resonance imaging in a patient with a unilateral congenital obstruction of the foramen of Monro by a transparent membranous septum was performed to enhance the orientation, achieve a better understanding of the pathology, and plan the surgical intervention in an endoscopic approach to the lateral ventricles. ⋯ Virtual MR endoscopy by using 3DFT-CISS sequences is a feasible method in the planning of intraventricular real-time endoscopic surgery, for the enhancement of orientation in a surgical field, and to achieve a better understanding of the pathology.
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Minim Invas Neurosur · Aug 2007
Case ReportsCombined endoscopically guided third ventriculostomy with prepontine cistern placement of the ventricular catheter in a ventriculo-peritoneal shunt: technical note.
The authors present the management of non-obstructive hydrocephalus using two surgical procedures, both at the same time: first, we perform an endoscopic third ventriculostomy and second, we place the ventricular catheter of the ventriculo-peritoneal shunt in the prepontine cistern under endoscopic guidance. The main rationale is the fact that the ventricular catheter passes through multiple fixed cerebrospinal fluid circulation points in order to allow the free circulation of the cerebrospinal liquid. The authors present here details of the technique and short-term results.
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Minim Invas Neurosur · Aug 2007
Pterional keyhole approach to middle cerebral artery aneurysms through an outer canthal skin incision.
The supraorbital keyhole approach via an eyebrow skin incision provides a method for the minimally invasive clipping of aneurysms located in the circle of Willis, but has disadvantages for aneurysms located in the lateral Sylvian fissure. The pterional keyhole minicraniotomy via an outer canthal skin incision is proposed for the clipping of unruptured aneurysms of the middle cerebral artery (MCA). ⋯ The pterional keyhole approach via outer an canthal skin incision is another treatment option for relatively small, unruptured MCA aneurysms.