Minim Invas Neurosur
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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
Case ReportsCombined treatment of ruptured aneurysm accompanied by intraventricular hemorrhage; neuroendoscopy and coiling: case report.
Subarachnoid hemorrhages with intraventricular hemorrhage (IVH) have been treated with aneurysmal clipping and ventricular drainage. We present a combined treatment with coiling and endoscopy: coiling of the ruptured distal anterior cerebral artery aneurysm and neuroendoscopic removal of IVH.
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Minim Invas Neurosur · Dec 2008
Case ReportsEndoscopic endonasal management of petroclival cerebrospinal fluid leaks: anatomical study and preliminary clinical experience.
Endonasal management of most anterior cranial fossa cerebrospinal fluid leaks is a well established procedure, and even some middle cranial fossa cerebrospinal fluid leaks can be managed safely endonasally. Endonasal endoscopic management of leakages of the posterior cranial fossa represents an unique challenge. ⋯ Endonasal endoscopic management of well-selected petroclival cerebrospinal fluid leaks is feasible.
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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.