Surg Neurol
-
Patients with limited intracranial metastatic disease traditionally have been treated with surgery followed by WBRT. However, there is growing concern for the debilitating cognitive effects after WBRT in long-term survivors. We present a series of patients treated with surgery followed by SRS, while reserving WBRT as a salvage therapy for disease progression. ⋯ Surgical resection combined with SRS is an effective treatment for selected patients with limited cerebral metastatic disease. Survival using this combined treatment was equivalent to or greater than that reported by other studies using surgery + WBRT or SRS + WBRT.
-
Editorial Biography Historical Article
Profiles in volunteerism Dr Albert Schweitzer: physician, humanitarian.
-
A transorbital intracranial injury with a wooden foreign body can be very difficult to diagnose and manage. The orbit forms an easy path for low-velocity foreign bodies into the intracranial space. The severity of the injury is often masked by unobtrusive superficial wounds. Computed tomography (CT) findings may be misinterpreted as pneumocephalus. ⋯ Although magnetic resonance imaging is more sensitive and specific, a CT angiogram with 3-dimensional reconstruction will provide much insight into the mode of intervention required. We present an anatomical classification for such injuries.
-
Randomized Controlled Trial
Evaluation of the skin flora after chlorhexidine and povidone-iodine preparation in neurosurgical practice.
Currently, there are various antiseptics used for cleaning the skin before surgery, but there is no standard procedure in practice. Chlorhexidine and povidone-iodine are the most preferred compounds among antiseptics. Both are proved to be safe and effective for skin disinfection. In this study, our aim was to investigate the combined effects of chlorhexidine and povidone-iodine on the skin's flora before neurosurgical intervention, consecutively. ⋯ Three minutes' cleaning of the incision area with chlorhexidine, followed by 30-second cleaning with povidone-iodine, could be a sufficient disinfection procedure for preoperative preparation of the skin in patients undergoing a neurosurgical procedure.
-
Of 756 percutaneous controlled radiofrequency thermocoagulations of gasserian ganglion and/or retrogasserian rootlets for idiopathic trigeminal neuralgia or for trigeminal neuralgia in multiple sclerosis, the results in 158 patients who had isolated third division trigeminal neuralgia were reviewed. ⋯ Percutaneous controlled radiofrequency thermocoagulation is quite easy to perform under fluoroscopic or CT control, and it involves no mortality and very low morbidity; it is an immediately effective procedure and the rate of recurrence is low. Last, but not least, if the anesthesia is limited to the third division, no anesthesia dolorosa occurs and patients are very grateful.