Minim Invas Neurosur
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Minim Invas Neurosur · Feb 2008
Comparative StudyOpen versus minimally invasive lumbar microdiscectomy: comparison of operative times, length of hospital stay, narcotic use and complications.
To determine if a minimally invasive approach to lumbar microdiscectomy reduces post-operative pain, length of hospital stay, or frequency of complications we retrospectively compared medical records of single level microdiscectomy patients by a single surgeon performed using a traditional open approach versus a minimally invasive approach. Thirty-five patients were in the open group: 63% male, average age 41.2 years, and 31 patients were in the minimally invasive group: 68% male, average age 42.1 years. There was no difference in surgical time or blood loss between the open and minimally invasive groups: 84.1 versus 76.8 minutes and 51.4 versus 69.7 mL, respectively. ⋯ The open group took an average of 11.7 mg oxycodone, the minimally invasive none. 45.2% of patients in the minimally invasive group were discharged on the same day as surgery compared to 5.75% in the open group (P=0.001). Microdiscectomy was performed safely and effectively through a minimally invasive expanding retractor system and operating microscope. Surgical times, blood loss, complications, and outcome were similar to a traditional open microdiscectomy while pain medication requirements and hospitalization were significantly less.
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Minim Invas Neurosur · Dec 2007
Microsurgical management of lateral ventricular meningiomas: a report of 51 cases.
Lateral ventricular meningiomas are notably rare and the optimal surgical management for them remains a challenge. We made a retrospective study of patients with these lesions and analyzed the clinical findings, radiological features and especially the surgical treatment on the basis of surgical approaches and techniques. ⋯ Understanding the features of lateral ventricular meningiomas will help one to select an appropriate surgical approach. An individualized approach is needed, and the transcortical parieto-occipital approach or transtemporal approach is advantageous for most cases in our opinion. Also, it is possible to achieve a good surgical outcome with little neurological morbidity if we take wise strategies and techniques during excision.
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Minim Invas Neurosur · Dec 2007
Endoscopic resection of colloid cysts: indications, technique, and results during a 13-year period.
Questions of recurrence and inadequacy of follow-up length persist regarding endoscopic treatment of colloid cysts. In this retrospective review, we report our long-term follow-up during a 13-year period in 35 patients who underwent endoscopic resection of colloid cysts. ⋯ Our series represents the longest follow-up (mean of 7.8 years) of colloid cysts after endoscopic resection. We now use this technique as the first line of treatment for colloid cysts. The risk of recurrence is minimal with gross total resection and/or coagulation of the cyst wall.
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Minim Invas Neurosur · Oct 2007
Neuronavigation and resection of lesions located in eloquent brain areas under local anesthesia and neuropsychological-neurophysiological monitoring.
The aim of this study was to determine the safety and maximal extension of tumor resection achievable with a combination of awake craniotomy under local anesthesia, neuronavigation, and continuous neuropsychological and neurophysiological monitoring in patients with lesions within the eloquent brain. ⋯ The combination of neuronavigation with cortical stimulation and repetitive neurological and language examinations allows a more radical resection of tumors in eloquent brain areas, otherwise considered as inoperable.
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Minim Invas Neurosur · Oct 2007
Historical ArticleConcept and treatment of hydrocephalus in the Greco-Roman and early Arabic medicine.
In the ancient medical literature hydrocephalus was not often described although its existence and symptomatology were well known. Most detailed descriptions of hydrocephalus including the surgical treatment are extant in the encyclopaedic works on medicine of the physicians Oreibasios and Aetios from Amida from the 4th and 6th centuries AD, respectively. Because of their broad scientific interests, this type of physicians, typical for the late Roman empire, were known as philosophy-physicians (iota alpha tau rho o sigma o phi iota sigma tau alpha iota). ⋯ Avicenna separated the traumatic haematomas outside the skull from the term hydrocephalus. However Avicenna, as all previous authors, had not linked hydrocephalus with the ventricular system. The autopsy of a child with an exorbitant hydrocephalus performed by the anatomist Vesalius in the 16th century revealed as a single pathology an extremely dilative ventricular system filled with water-like fluid which made it necessary to change completely the ancient concept of hydrocephalus.