Acta neurochirurgica
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Acta neurochirurgica · Sep 2009
Case ReportsRuptured subclavian artery pseudo-aneurysm associated with Neurofibromatosis type 1.
A subclavian artery aneurysm associated with Neurofibromatosis type 1 (NF 1) is extremely rare. We report a ruptured pseudo-aneurysm of the subclavian artery in a patient with NF 1 treated with endovascular surgery. ⋯ Our patient is the first reported example of successful endovascular treatment for a ruptured subclavian artery pseudo-aneurysm associated with NF 1. Endovascular stenting and coil embolisation for the ruptured subclavian artery pseudo-aneurysm was very effective.
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Acta neurochirurgica · Sep 2009
Detection of tumour invasion into the pyramidal tract in glioma patients with sensorimotor deficits by correlation of (18)F-fluoroethyl-L: -tyrosine PET and magnetic resonance diffusion tensor imaging.
Standard magnetic resonance imaging (MRI) does not depict the true extent of tumour cell invasion in gliomas. We investigated the feasibility of advanced imaging methods, i.e. diffusion tensor imaging (DTI), fibre tracking and O-(2-[(18)F]-fluoroethyl)-L: -tyrosine ((18)F-FET) PET, for the detection of tumour invasion into white matter structures not visible in routine MRI. ⋯ Our data show an association between preoperative sensorimotor deficits, increased (18)F-FET uptake and decreased FA ratio in the pyramidal tract. We demonstrated a correlation between tumour invasion and (18)F-FET uptake. These findings may help to distinguish between edema versus tumour-associated neurological deficits and could prevent the destruction of important structures, like the pyramidal tract, during tumour operations by allowing more precise preoperative planning.
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Acta neurochirurgica · Sep 2009
How often does an incomplete circle of Willis predispose to cerebral ischemia during closure of carotid artery? Postmortem and clinical imaging studies.
To evaluate the prevalence of anatomical variations in the circle of Willis predisposing to cerebral ischemia during intraoperative closure of a carotid artery. ⋯ Incomplete circle of Willis predisposes approximately one-sixth of individuals to cerebral ischemia during transient closure of carotid artery but the risk is more than threefold in case of contralateral ICA occlusion.
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Acta neurochirurgica · Sep 2009
Comparative StudyA comparison between surgical resection in combination with WBRT or hypofractionated stereotactic irradiation in the treatment of solitary brain metastases.
The standard treatment of solitary brain metastases previously has been tumour resection in combination with whole-brain radiation therapy (WBRT). Stereotactic radiotherapy has emerged as a non-invasive treatment option especially for small brain metastases. We now report our results on resection + WBRT or hypofractionated stereotactic irradiation (HCSRT) in the treatment of solitary brain metastases. ⋯ This retrospective and non-randomised study indicates that surgical resection in combination with WBRT may be an option even for small brain metastases suitable for treatment with HCSRT. Since survival and local control following resection + WBRT was at least as favourable as compared to HCSRT alone, tumour location and expected neurological outcome may be the strongest aspect when selecting treatment modality.