World Neurosurg
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The transoral transpharyngeal surgical approach is a recognized technique for management of ventral lesions at the clivus and upper cervical spine. This report examines the use of neuronavigation and intraoperative magnetic resonance imaging as surgical adjuncts for lesions in this region. ⋯ Intraoperative MRI and neuronavigation are valuable adjuncts that allow selective surgical exposure and confirmation of surgical objectives within the narrow surgical corridor provided by a transoral approach to the craniovertebral junction.
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We evaluated the effects of gamma-knife radiosurgery (GKRS) on the cognitive functioning of patients with a pituitary adenoma. ⋯ We found no evidence that GKRS impairs the neurocognitive functioning of patients with pituitary disease above any impairment caused by the disease itself. Further studies will require approximately 20 patients in each comparison group to confirm this result.
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Infection remains the most significant complication of ventriculoperitoneal shunt surgery and the reported rates of cerebrospinal fluid shunt infection vary widely across studies in patients with hydrocephalus. The objective of this study is to review and evaluate the infections complicating ventriculoperitoneal shunt surgery in patients with hydrocephalus. ⋯ Infection remains the most serious complication of ventriculoperitoneal shunt surgery. The findings of this retrospective study show that gender, age, and etiology of hydrocephalus significantly correlated independently with the incidence of infection. Prospective studies are needed to assess the observed associations between the risk factors and incidence of infection in hydrocephalus patients treated with ventriculoperitoneal shunt surgery.
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Because the early risk of stroke recurrence in patients with posterior circulation infarctions is high, patients with vertebrobasilar events require active preventive treatment. Previous reports have described the use of balloon angioplasty and stenting or surgical revascularization to the vertebrobasilar artery area. To compensate for the disadvantages of these techniques, we combined endovascular and surgical treatments in a patient with symptomatic vertebrobasilar artery stenosis. ⋯ Our staged therapy may be an effective treatment for symptomatic vertebrobasilar artery stenosis.