Minim Invas Neurosur
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Minim Invas Neurosur · Sep 2002
Cubital tunnel syndrome. Treatment by decompression without transposition of ulnar nerve.
Cubital tunnel syndrome is the second most common entrapment neuropathy in the upper limb; however, surgical treatment of the ulnar nerve entrapment at the elbow remains controversial. None of the presently advocated procedures (simple decompression of the ulnar nerve, medial epicondylectomy, subcutaneous, submuscular or intramuscular anterior transposition of the ulnar nerve) has proven optimal regarding long-term results. This paper presents the experience of treating cubital tunnel syndrome with simple decompression in 40 patients. ⋯ Three patients did not demonstrate any improvement (7.5 %). The mean duration of postoperative disablement in our working patients (18/40) was 28 days. In summary, simple decompression of the ulnar nerve seems to be an adequate and successful minimally invasive technique for the treatment of cubital tunnel syndrome.
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Minim Invas Neurosur · Sep 2002
Case ReportsSuccessful endovascular treatment of a spinal dural arteriovenous fistula with trisacryl gelatin microspheres.
We report on the endovascular treatment of a spinal dural arteriovenous fistula (SDAVF) in a 50-year-old man, who presented with rapidly progressive paraparesis of lower extremities. Standard treatment of SDAVFs is by either embolization with liquid adhesive agents like NBCA or microsurgery. In our case the fistula was successfully occluded by application of trisacryl gelatin microspheres (TGM). ⋯ It also displayed a clinically silent focal ischaemia within the spongiosa of an adjacent hemi-vertebra due to particle passage through intersegmental vascular collaterals. A control angiogram confirmed the disappearance of the fistula. The patient underwent physiotherapy and experienced significant improvement of his gait within three months after intervention.
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Minim Invas Neurosur · Mar 2002
Case ReportsNeuroendoscopic third ventriculostomy in a patient with occluded foramen of Monro: a case report.
We treated recurrent hydrocephalus in a previously shunted patient by neuroendoscopic third ventriculostomy. A tear was noted in the septum pellucidum. As the foramen of Monro was found to be occluded, we first fenestrated the floor of the lateral ventricle and then performed third ventriculostomy through the fenestration. ⋯ Cerebrospinal fluid pulsation appeared after fenestration of this membrane. These obstructions presumably resulted from congenital and/or inflammatory causes. In cases such as this, successful neuroendoscopic third ventriculostomy presents a challenge to surgical judgment.
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Minim Invas Neurosur · Dec 2001
Case ReportsRecurrent cubital tunnel syndrome. Etiology and treatment.
Controversy surrounds the treatment of recurrent cubital tunnel syndrome after previous surgery. Irrespective of the surgical technique, namely pure decompression in the ulnar groove and the cubital tunnel distal of the medial epicondyle, and the different methods of volar transposition (subcutaneous, intramuscular, and submuscular), the results of surgical therapy of cubital tunnel syndrome are often not favorable, especially in cases of long-standing symptoms and severe deficits. Twenty-two patients who had previously undergone surgical treatment for ulnar nerve entrapment at the elbow were evaluated because of persistent or recurrent pain, paresthesia, numbness, and motor weakness. ⋯ The recovery of motor function and return of sensibility were variable and unpredictable. In summary, reoperation after primary surgery of cubital tunnel syndrome gave satisfactory results in 18 of 22 cases. Subsequent transfer of the ulnar nerve back into the sulcus promises to be useful in cases in which subcutaneous transposition had not been successful.
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Minim Invas Neurosur · Dec 2001
Gamma knife radiosurgery in meningiomas of the posterior fossa. Experience with 62 treated lesions.
This study was undertaken to assess the role of the gamma knife (GK) in the treatment of meningiomas of the posterior cranial fossa (PCF) and to statistically analyze the predictability of arbitrarily-selected prognostic factors in such treatment. ⋯ The excellent results obtained for TGC with minimal associated side effects suggest that GK is an effective therapeutic tool also for treatment of PCF meningiomas.