Minim Invas Neurosur
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Minim Invas Neurosur · Feb 2006
Endoscopic transsphenoidal treatment in recurrent and residual pituitary adenomas--first experience.
The aim of the study has been the assessment of the endoscopic method in the surgical management of recurrent and residual pituitary adenomas, as concerns treatment efficiency, substantial complications, and its possible advantages for the operating surgeon and patient. ⋯ The endoscopic method is a safe, hardly invasive and efficient surgical technique in the treatment of recurrent and residual pituitary adenomas. Advantages which add to its attractiveness are also reduction of the procedure duration, very good visualisation of the operative field, absence of serious complications, less pain experienced after the surgery.
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Minim Invas Neurosur · Feb 2006
Design and microsurgical anatomy of the retrosigmoid-retrocondylar keyhole approach without occipital condyle removal.
The goal of this study was to design a new retrosigmoid-retrocondylar keyhole approach based on the minimally invasive keyhole idea and to explore its feasibility and indications, which can be regarded as the base of this keyhole approach in clinical use. ⋯ The novel retrosigmoid-retrocondylar keyhole approach has practical value for clinical applications. With the techniques of modern microsurgery, several diseases such as an aneurysm situated at the vertebral artery or the posterior inferior cerebellar artery, a small hypoglossal neurinoma and tumor located at the ventral lateral aspect of the medulla oblongata, may be operated via this retrosigmoid-retrocondylar keyhole approach without drilling the occipital condyle.
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Minim Invas Neurosur · Dec 2005
Case ReportsMinimally invasive management of ependymoma of the aqueduct of Sylvius: therapeutic considerations and management.
A major concern in the neuroendoscopic approach to an intraventricular tumor is the histological confirmation from a limited biopsy. However, the effort to excise the whole bulk of the tumor should be made for the minimally invasive management of selected intraventricular tumors. The case of an adult male with focal aqueductal ependymoma who presented with the clinical syndrome of hydrocephalus is reported. This may be of particular interest because it represents the first case of aqueductal ependymoma that has been successfully treated with endoscopic surgery.
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Minim Invas Neurosur · Dec 2005
Clinical application of artificial dura mater to avoid cerebrospinal fluid leaks after microvascular decompression surgery.
Although technological advances combined with many surgical innovations have helped to minimize its occurrence, cerebrospinal fluid (CSF) leak still remains to be one of the most common postoperative complications following microvascular decompression (MVD) surgeries. The objectives of this study are 1) to detail our experience with the clinical application of artificial dura mater for the avoidance of CSF leaks in a group of 103 patients who underwent MVD surgeries and 2) to compare the results of CSF leak and deep wound infection between the group with and one without using artificial dura mater. ⋯ The use of the artificial dura mater in the closure procedure of MVD surgery seems to be a safe and effective way to prevent CSF leaks. However, further investigations on a larger number of cases still need to be done to substantiate its validity.
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Subarachnoid hemorrhage (SAH) often results in devastating neurological deficits requiring hospitalization and loss of independence. This is often a difficult time for patients and their families who are struggling to cope with this sudden illness. Current treatment options include surgical clipping of the aneurysm or endovascular obliteration using Guglielmi detachable coils. Our purpose in writing this paper was to review the factors that determine the choice of treatment. In addition to this we wanted to study the benefits of surgical clipping for ruptured aneurysms over endovascular coiling. ⋯ Based on this study we were able to formulate a few definite indications for clipping, even in the times of advanced endovascular techniques. In addition we could also prove the benefits of surgical clipping over the endovascular technique in severe subarachnoid hemorrhage.