Minim Invas Neurosur
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Minim Invas Neurosur · Jun 2004
Case ReportsSuccessful staged treatment for ruptured blister-like dissecting aneurysm of the intracranial internal carotid artery: acute GDC embolization for the blister-like aneurysm followed by proximal occlusion with extracranial-intracranial bypass in the chronic stage.
The surgical treatment of ruptured blister-like dissecting aneurysm on the internal carotid artery (ICA) is still controversial. We report a case of this disease successfully managed by a staged treatment: GDC packing into the blister-like aneurysm in the acute stage followed by proximal occlusion in the chronic stage. The merit of this staged treatment is to prevent rerupture in the acute stage and to allow the proximal occlusion in the chronic stage with or without an extracranial-intracranial bypass, after assessment of tolerance of the ICA occlusion.
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Minim Invas Neurosur · Apr 2004
Historical ArticleRole of women in medicine: a look at the history, the present condition and the future status of women in the surgical field, especially neurosurgery.
We have analyzed the historical background of women's progress in medicine in Japan and the role of female neurosurgeons as models for the next generation. Female neurosurgeons were asked to complete a questionnaire regarding their professional life in detail and the problems they are facing while managing their personal life after getting married and having a child. Some feel that there remain some constraints at work for being a female, due to their male colleagues who are not so understanding in nature. ⋯ Certain measures to encourage females to take up surgery are providing more time by arranging care for babies and families, flexibility in working hours, in addition to having a considerate husband and a considerate chief of department and senior staff. Departmental policies need to be completely impartial and should promote everyone based on their skills and knowledge. Women neurosurgeons need to get together and discuss all these issues so that the younger generation will not hesitate to take up this profession and become stalwarts of neurosurgery like their male counterparts.
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Minim Invas Neurosur · Apr 2004
Clinical TrialDecompression without anterior transposition: an effective minimally invasive technique for cubital tunnel syndrome.
Cubital tunnel syndrome represents the second most common compression neuropathy in the upper limb. There are three main surgical procedures to deal with this issue, namely simple decompression, medial epicondylectomy and anterior transposition. Nevertheless, optimal surgical treatment is still open to question. ⋯ Evaluation of conduction velocities showed highly significant improvements for both motor and sensory conduction velocities. In summary, simple decompression, if necessary modified with external neurolysis and epineuriotomy, showed high success rates in all stages. Decompression is a minimally invasive procedure, but very effective for mild as well as for severe cases and therefore the optimal treatment in cubital tunnel syndrome.
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Symptomatic lumbar juxta facet cysts (ganglion and synovial cysts) (JFC) are uncommon lesions of the spine, causing radiculopathy and low back pain. The authors present their experiences with microsurgically treated JFC. This rare pathology is discussed with special focus on therapeutic concepts and long-term outcome. ⋯ Adequate and definitive treatment in symptomatic JFC consists in microsurgical resection. A partial hemilaminectomy is sufficient for surgical exposure. Excellent long-term outcome can be achieved. Recurrences and surgical complications are rare.
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Minim Invas Neurosur · Dec 2003
Case ReportsSurgical strategies for treatment of giant or large intracranial aneurysms: our experience with 139 cases.
Giant or large intracranial aneurysms are the vascular neurosurgeon's greatest challenge. At our department, we have treated one hundred and thirty nine patients with giant or large intracranial aneurysms between 1975 and 2001. These included 37 partially thrombosed giant aneurysms. 75 aneurysms were giant (> 2.5 cm) and 64 were large aneurysms (2-2.5 cm). ⋯ While selecting surgical strategy for partially thrombosed giant aneurysm, securing the neck is most important. If the neck is too narrow to reconstruct, aneurysmectomy with anastomosis is one of the surgical strategies. An extracranial intracranial bypass should be considered in cases where clipping or parent artery ligation is expected to be associated with compromise of cerebral circulation.