Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Oct 2009
Microsurgical treatment for typical pituitary apoplexy with 44 patients, according to two pathological stages.
The aim of this study was to explore the pathogenesis of typical pituitary apoplexy in different periods, to help to formulate a reasonable treatment program and to select the correct operation time. ⋯ Typical pituitary apoplexy is mainly caused by hemorrhage secondary to necrosis after infarction. The staging of this disease provides an important guidance value to diagnosis and treatment. The surgical outcomes in the late stage were significantly better than those in the early stage. The patients without significant symptoms can be conservatively treated by hormone substitution therapy.
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Minim Invasive Neurosurg · Oct 2009
Case ReportsMinimally invasive approaches to treating chemosis of the eyes from unusual dural arteriovenous fistulae.
Chemosis of the eyes is usually attributed to carotid cavernous sinus dural arteriovenous fistulae. Herein, we reviewed unusual cases in which chemosis of the eyes originated from dural ateriovenous fistulae (dAVFs) that were distinctly different from carotid cavernous sinus fistulae. ⋯ Several different types of dural AVFs were associated with chemosis, and these included dAVFs harboring a feeding artery from branches of the external carotid artery directly draining to the superior ophthalmic vein or cavernous sinus via the superior petrous sinus, posterior fossa dAVFs draining via the inferior petrous sinus and cavernous sinus to the ophthalmic vein, a fistula between the ophthalmic artery or branches of the internal carotid artery and inferior ophthalmic vein, or tentorial fistula with a drainage vein to the cavernous sinus via the vein of Galen. This study reviews the symptomatology, treatment options, and cerebrovascular abnormalities observed for these unusual dAVF's with chemosis.
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Minim Invasive Neurosurg · Oct 2009
Comparative StudyEffectiveness, security and height restoration on fresh compression fractures--a comparative prospective study of vertebroplasty and kyphoplasty.
Painful fractures of the spine pose a serious clinical problem which gains in importance with the increasing ageing of our population. When conservative treatment of these fractures fails, with vertebroplasty and kyphoplasty we have two percutaneous minimally invasive stabilising procedures at our disposal. ⋯ This study compares vertebroplasty and kyphoplasty with regard to their effectiveness, safety, and restoration of vertebral body height, and complications. There were no differences between the groups with regard to quality of life and pain improvement, but the rate of serious complications was higher after vertebroplasty. Mean vertebral body height restoration at 1 year follow-up was significantly higher (p<0.05) in the kyphoplasty group. It remains to be seen in future long-term studies whether or not restoration of vertebral body height has an effect on the clinical result.
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Minim Invasive Neurosurg · Oct 2009
Risk factors for regrowth of intracranial meningiomas after gamma knife radiosurgery: importance of the histopathological grade and MIB-1 index.
The influence of histopathological grade and MIB-1 index of intracranial meningioma on the results of its radiosurgical management is not clear. The objective of the present retrospective study was to make an evaluation of these factors along with an analysis of other variables associated with progression-free survival after gamma knife radiosurgery (GKR). ⋯ Radiosurgery is a highly effective management option for benign intracranial meningiomas, but growth control of non-benign ones is significantly worse. It requires close neuroradiological follow-up and necessitates the search for modified treatment strategies.
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Minim Invasive Neurosurg · Oct 2009
Case ReportsThe combined supraorbital keyhole-endoscopic endonasal transsphenoidal approach to sellar, perisellar and frontal skull base tumors: surgical technique.
Extended endoscopic endonasal transsphenoidal approaches (extended EETA) are increasingly being explored for lesions around the sella and the frontal skull base. These approaches, however, require significant surgical expertise and training that can only be obtained in high-volume centers and therefore these approaches are not generalizable to the whole neurosurgical community. Also, these approaches require significant skull base destruction and reconstruction, which comes with a high risk of CSF fistulas. The aim of this article is to describe a combined supraorbital keyhole-endoscopic endonasal transsphenoidal approach as an alternative surgical strategy to the extended EETA that is easier to perform and that leaves the skull base anatomy more intact. ⋯ The combined supraorbital keyhole-EETA approach can be used without extra surgical training or expertise and with preservation of skull base anatomy for sellar, perisellar and frontal skull base tumors.