Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Jun 2009
Surgical management of bilateral middle cerebral artery aneurysms via a unilateral supraorbital key-hole craniotomy.
Surgical management of multiple intracranial aneurysms may be difficult if located bilaterally. In the case of bilateral middle cerebral artery (MCA) aneurysms, surgical treatment through a unilateral approach is generally not recommended. In this study we describe the surgical technique and important factors that enable treatment of bilateral MCA aneurysms via a unilateral key-hole approach. ⋯ Bilateral aneurysms of the MCA may be treated sufficiently through a unilateral supraorbital key-hole approach in selected patients. This is also possible in patients presenting with SAH. Factors necessitating bilateral craniotomies were brain swelling and complex configuration of the contralateral aneurysm.
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Minim Invasive Neurosurg · Jun 2009
Case ReportsMinimally invasive thoracic corpectomy and anterior fusion in a patient with metastatic disease: case report and review of the literature.
For patients with metastatic disease to the spine there are numerous surgical approaches for decompression of neural elements and maintenance of mechanical stability. The challenge is to accomplish this while minimizing patient morbidity. Here we report on the feasibility and utility of a minimally invasive extreme lateral approach to the mid to high thoracic spine for anterior decompression and fusion.
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Minim Invasive Neurosurg · Jun 2009
Endoscopic suboccipital decompression on pediatric Chiari type I.
To minimize the invasiveness and maximize the adequacy of Chiari decompression on pediatric patients, 0 degrees and 30 degrees endoscopes were adapted to perform the procedure of suboccipital craniectomy and upper cervical laminectomies. ⋯ The use of the endoscope through a suboccipital craniectomy and upper cervical laminectomies has made Chiari decompression in pediatric population comparable with the conventional procedure in terms of minimal surgical invasiveness, recovery time, and complexity of the procedure.
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Minim Invasive Neurosurg · Apr 2009
Surgical experience of unilateral laminectomy for bilateral decompression (ULBD) of ossified ligamentum flavum in the thoracic spine.
We describe a new surgical technique for the treatment of ossified ligamentum flavum (OLF) in the thoracic spine through unilateral laminectomy for bilateral decompression (ULBD). ⋯ ULBD is a safe and effective non-fusion technique that provides a good surgically decompressed field. A potential increase in kyphosis following laminectomy can be avoided by this surgical technique, also it preserves the contralateral facet joint, the lamina and the midline ligament structures, while widening the spinal canal.
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Minim Invasive Neurosurg · Apr 2009
Case ReportsCoil migration after endovascular coil occlusion of internal carotid artery pseudoaneurysms within the sphenoid sinus.
We report two cases of coil migration after endovascular treatment of pseudoaneurysm of the internal carotid artery within the sphenoid sinus with coils and noncovered stents. ⋯ Pseudoaneurysms of the internal carotid artery are a special entity and the environment of the aneurysm within the sphenoid sinus may change over a long time. Coil embolization may lead to the late onset complication of coil migration with the possible risk of acute epistaxis. As a consequence, these patients need a careful and prolonged follow up. FD-CT is an appropriate technique to visualize the implanted coils and if present the migration of coil material.