Minim Invas Neurosur
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Minim Invas Neurosur · Apr 2007
Comparative StudyComparison of frame-based and frameless stereotactic hematoma puncture and subsequent fibrinolytic therapy for the treatment of supratentorial deep seated spontaneous intracerebral hemorrhage.
This study compared the technical implications and clinical outcome of patients treated for an intracerebral hemorrhage using two minimally invasive procedures: frame-based stereotactic hematoma aspiration and frameless navigation-guided hematoma aspiration followed by fibrinolysis. ⋯ The frame-based group and the frameless group followed by fibrinolysis had similar outcomes, and both procedures effectively reduced the intracerebral hemorrhage volume within a short period of time. In addition, these procedures are simple, precise, safe, and brief with a very low rebleeding rate and mortality.
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Minim Invas Neurosur · Apr 2007
Neuronavigation-assisted surgery for distal anterior cerebral artery aneurysm.
We present our experience with the neuronavigation system used for surgery of distal anterior cerebral artery (DACA) aneurysms. ⋯ Although current neuronavigation systems are not available for all intracranial aneurysms, we believe that the DACA aneurysm is a good candidate for its use. The additional benefits of a small craniotomy and precise intraoperative orientation during surgery result in a minimally invasive aneurysm procedure.
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Minim Invas Neurosur · Apr 2007
Intracranial pressure changes during Valsalva manoeuvre in patients undergoing a neuroendoscopic procedure.
The Valsalva manoeuvre results in an increase in intrathoracic pressure which alters the systemic and cerebral circulations significantly. We decided to record changes in the intracranial pressure and cerebral perfusion pressure resulting from a Valsalva manoeuvre in anaesthetised patients. ⋯ There was a significant reduction in cerebral perfusion pressure during the Valsalva manoeuvre in both stages. This was a result of change in either the intracranial pressure or the mean arterial pressure. Although our patients did not suffer a clinically significant reduction in cerebral perfusion pressure and so had an uneventful recovery, the effect of Valsalva manoeuvre on cerebral perfusion pressure cannot be denied. The marked haemodynamic changes clearly warrant a cautious use of this manoeuvre in neurosurgical practice.
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Minim Invas Neurosur · Apr 2007
Combined subtemporal and retrosigmoid keyhole approach for extensive petroclival meningioma surgery: report of experience with 7 cases.
Resection of petroclival meningiomas offers great challenges to the neurosurgeons. Our experience of 7 cases using a combined subtemporal and retrosigmoid keyhole approach surgery was evaluated for the treatment of extensive petroclival meningiomas. ⋯ The combined keyhole approach is suitable for the treatment of extensive petroclival meningiomas. It provides easy and quick access to the supra- and infratentorial juxtaclival region without any petrous bone drilling. Complications related to the approach can be minimized.
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This study was made to define the mechanism of endoscopic third ventriculostomy (ETV) in the various forms of hydrocephalus. ⋯ The relatively high rate of success of ETV in various forms of hydrocephalus and the intraoperative finding of mobility of the third ventricle floor after the stomy suggest that the first mechanism of the ETV is the restoration of pulsatility of the ventricular walls. This results in restoration of the CSF flow from the ventricular system into the subarachnoid spaces and normalization of the CSF dynamics. Accordingly, ETV is not only an internal shunt, but it primarily influences the capacity of the brain pulsatility to ensure CSF flow.