Acta neurochirurgica
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Acta neurochirurgica · Oct 2011
Case ReportsEndoscopic third ventriculostomy for hydrocephalus after perimesencephalic subarachnoid hemorrhage: initial experience in three patients.
To review the outcome after endoscopic third ventriculostomy (ETV) for symptomatic, persistent hydrocephalus in three patients with perimesencephalic angiographically negative subarachnoid hemorrhage (PNH) who were dependent on an external ventricular drain (EVD). ⋯ To our knowledge, this is the first report of ETV for PNH with hydrocephalus and the first report of a basilar tip microaneurysm seen intraoperatively during ETV. ETV is a viable treatment option for refractory hydrocephalus secondary to a perimesencephalic pattern of subarachnoid hemorrhage (SAH). Its early application can avoid placement of a ventriculoperitoneal shunt, curtail the extended use of an EVD, and reduce the associated infection risks. Despite thorough angiographic investigation for an aneurysmal cause of SAH, a "microaneurysm" of the basilar artery was found at ETV. No complication or rebleeding was encountered.
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Acta neurochirurgica · Oct 2011
Case ReportsNerve transfers using collateral branches of the brachial plexus as donors in patients with upper palsy--thirty years' experience.
Nerve transfers in cases of directly irreparable or high-level extensive brachial plexus traction injuries have been done using a variety of donor nerves with various success, but an ideal method has not been established. The purpose of this study is to analyze the results of nerve transfers using the thoracodorsal and medial pectoral nerves as donors in patients with upper palsy. ⋯ According to our findings, nerve transfers using collateral branches of the brachial plexus in cases with upper palsy offer several advantages and yield high rate and good quality of recovery.
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Acta neurochirurgica · Oct 2011
Chemoport with a non-collapsible chamber as a replacement for an Ommaya reservoir in the treatment of leptomeningeal carcinomatosis.
The Ommaya reservoir for intraventricular chemotherapy of leptomeningeal carcinomatosis (LMC) patients has been reported to have some complications. We introduced a Chemoport reservoir, with a solid non-collapsible, high-profile chamber as a the replacement for the Ommaya reservoir in LMC patients. ⋯ Chemoport, as a reservoir for intraventricular chemotherapy, has superior ICP control at an equal or lower rate of complications compared with the Ommaya reservoir.
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Acta neurochirurgica · Oct 2011
Case ReportsJuvenile psammomatoid ossifying fibroma of the orbit and paranasal sinuses. A case report.
Juvenile psammomatoid ossifying fibroma (JPOF) is an uncommon benign fibro-osseous lesion predominantly arising in the paranasal sinuses and orbits of children and young adults. We report a case of JPOF involving the paranasal sinuses and orbit in a 15-year-old boy that presented due to progressive proptosis and downward displacement of the left eye. The lesion, first described as fibrous dysplasia (FD), was totally removed surgically, and then proved to be a JPOF, by histopathology. We discuss its differential diagnosis with other fibro-osseous lesions, histopathological features, and treatment options.
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Acta neurochirurgica · Oct 2011
Case ReportsIntraoperative monitoring of the visual function using cortical potentials after electrical epidural stimulation of the optic nerve.
Central skull base meningiomas commonly present with visual deficit, and their removal often leads to improvement of visual function. However, the incidence of postoperative visual deterioration has been reported to be up to 10%. Intraoperative monitoring using flash visual evoked potential has only recently been used with success. Cortical potentials (CP) after electrical epidural stimulation of the optic nerve (ON) were correlated with ON manipulation due to central skull base tumor removal to contribute to improvement of the intraoperative monitoring of the visual function. ⋯ P20 and N30 amplitude changes seem to reliably correspond with the manipulation of ON during anterior skull base tumor removal. Reversible reduction of P20 and N30 amplitude was associated with unchanged immediate postoperative visual function. No correlation between intraoperative variation of CP and newly acquired postoperative visual deficit can presently be made.