Acta neurochirurgica
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Acta neurochirurgica · Nov 2009
Significance of serial S100b and NSE serum measurements in surgically treated patients with spondylotic cervical myelopathy.
Predicting functional outcome following surgery performed for spinal cord compression is still a considerable problem. Recent observations, though, strongly suggest that with serial measurements of serum S100b, this might be possible in patients with subacute spinal cord compression. The aim of this study was to examine whether this potential significance of S100b applies as well to patients with spondylotic cervical myelopathy. A further purpose was to assess the value of NSE in this regard, another biochemical marker widely used to monitor cerebral lesions. ⋯ Serial S100b serum measurements do not permit prediction of functional outcome in patients with spondylotic cervical myelopathy in case of an uncomplicated postoperative course. In complicated courses with postoperative deterioration, such measurements reflect postoperative events with possibly prognostic relevance. NSE does not have any significance in these patients with chronic lesions of the spinal cord.
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Acta neurochirurgica · Nov 2009
Long-term outcome and survival of surgically treated supratentorial low-grade glioma in adult patients.
The appropriate management of low-grade gliomas is still a matter of debate. So far, there are no randomized studies that analyze the impact of surgical resection on patient outcome. The value of the data obtained from the few retrospective reports available is often limited. ⋯ In summary, we could retrospectively evaluate a large case series of well-defined low-grade gliomas patients with a long follow-up period showing that extended surgery would be the most effective therapy for low-grade glioma patients even in recurrent diseases.
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Acta neurochirurgica · Nov 2009
Dural suturing for repair of cerebrospinal fluid leak in transnasal transsphenoidal surgery.
Repair of a cerebrospinal fluid (CSF) leak after transsphenoidal surgery (TSS) is usually accomplished using various graft materials. These methods are effective in most, but not all, cases. ⋯ Direct suturing of the sellar dura is a simple, safe, and reliable surgical technique for repairing CSF leaks after TSS. Using this procedure, more than 70% of patients with an intraoperative CSF leak can avoid autologous tissue grafts.
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Acta neurochirurgica · Nov 2009
Case ReportsMultidrug-resistant Acinetobacter baumannii ventriculitis: successful treatment with intraventricular colistin.
Acinetobacter baumannii has emerged as an important nosocomial pathogen that can cause a multitude of severe infections. In neurosurgical patients the usual presentation is ventriculitis associated with external ventricular drainage. ⋯ We review the literature concerning intraventricular use of colistin (polymyxin E) for A. baumannii ventriculitis and add three cases successfully treated with this method. Our experience suggests that intraventricular colistin is a potentially effective and safe therapy for the treatment of multidrug-resistant A. baumannii central nervous system infections.
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Acta neurochirurgica · Nov 2009
Treatment of cervical OPLL by cervical anterior fusion using autologous vertebral bone grafts.
In anterior fusion, we use autologous bone grafts from cervical vertebral bodies and bioabsorptive screws to prevent graft extrusion (Williams-Isu method). We report the application of and indication for the Williams-Isu method for OPLL and present our clinical and radiological results. ⋯ The Williams-Isu method is useful for treating not only cervical spondylosis but also cervical segmental OPLL at one or two levels.