Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Oct 2011
Case ReportsDecompression procedure using a microendoscopic technique for thoracic myelopathy caused by ossification of the ligamentum flavum.
Microendoscopic discectomy (MED) is one of the minimally invasive endoscopic procedures for treating lumbar disc herniation. The aim of this case report is to describe a patient with thoracic ossification of the ligamentum flavum (OLF) that was completely removed using the microendoscopic technique. ⋯ The authors found that the microendoscopic technique could be applied to decompression surgery for thoracic OLF. The procedure could provide a sufficient decompression with minimum damage to the paraspinal muscles. However, the microendoscopic procedure should be indicated only for select thoracic OLF, such as OLF without fusion at the middle of the spinal canal and OLF without dural ossification, because of its technical difficulties.
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Minim Invasive Neurosurg · Oct 2011
Individualized pterional keyhole clipping surgery based on a preoperative three-dimensional virtual osteotomy technique for unruptured middle cerebral artery aneurysm.
Individualized surgical simulation using three-dimensional (3D) imaging to allow safe performance of clipping surgery for unruptured middle cerebral artery (MCA) aneurysm via pterional keyhole mini-craniotomy was performed in 100 consecutive patients. ⋯ Pterional keyhole clipping surgery based on careful surgical simulation with 3D images is a safe and less invasive means to treat relatively small unruptured MCA aneurysms.
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Minim Invasive Neurosurg · Oct 2011
Case ReportsStereotactic brainstem biopsy in a patient with coagulopathy of unclear etiology: case report.
Parenchymal hemorrhage is one of the most feared risks of stereotactic brain biopsies potentially resulting in neurological deficits or even a fatal outcome. Patients with disorders of the coagulation system are at particular risk, so identifying these is one of the main tasks prior to surgery. Some patients may have a bleeding tendency despite normal laboratory values of the hemostatic system. ⋯ A medication scheme with tranexamic acid and desmopressin effectively decreased the patient's bleeding time in vivo and the procedure was carried out without complications.
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Minim Invasive Neurosurg · Aug 2011
Simple, effective, supine positioning for the retrosigmoid approach.
The retrosigmoid approach is often used for posterior fossa pathology. Many variations of positioning exist. Here, we report a simple, safe, and quick positioning technique which maximizes patient safety, surgeon comfort, and intraoperative view. ⋯ Supine positioning for the retrosigmoid approach is an excellent and safe positioning alternative.
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Minim Invasive Neurosurg · Aug 2011
Review Case ReportsNeuroendoscopic management of intraventricular germinoma at the foramen of Monro: case report and review of the literature.
Intraventricular tumors account for approximately 3% of adult brain tumors and 16% of childhood and adolescent brain tumors. Half of the intraventricular tumors in adults and one quarter of those in children are found in the lateral ventricles. Ependymoma, astrocytoma, oligodendroglioma, choroid plexus papilloma, meningioma and subependymal giant cell astrocytoma are the common tumors encountered at this particular site. A germinoma at this site is rare. Microsurgery of intraventricular tumors can be challenging and is performed with potential functional and cognitive complications. ⋯ This report suggests that in selected cases endoscopic resection of an intraventricular tumor under frameless neuronavigation guidance is feasible and safe. The target can be precisely located and procedure-related adverse events can be minimized.