Acta neurochirurgica
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Acta neurochirurgica · May 2012
Clinical TrialDiscovery of a new waveform for intraoperative monitoring of hemifacial spasms.
Surgeons often rely on intraoperative electrophysiological monitoring to determine whether decompression is sufficient during microvascular decompression surgery for hemifacial spasms. A new monitoring method is needed when an abnormal muscle response is occasionally not available or is unreliable. This study was an observational clinical trial exploring a new waveform recorded from the facial muscles while the offending artery wall was electrically stimulated. ⋯ We found a new waveform for intraoperative monitoring of hemifacial spasm. The Z-L response was useful when the abnormal muscle response was absent before decompression or persisted after all vascular compressions were properly treated. Particularly, the Z-L response may help neurosurgeons determine the real culprit when multiple offending vessels exist.
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Acta neurochirurgica · May 2012
Seizure outcome with surgical management of epileptogenic ganglioglioma: a study of 55 patients.
Ganglioglioma is a common seizure-associated tumor, and some factors that may influence the postoperative seizure outcome have not been discussed or are controversial. The goal of this study was to observe the postoperative seizure outcome and the prognostic factors in patients with epileptogenic gangliogliomas. ⋯ Surgical treatment is effective and safe for patients with epileptogenic gangliogliomas. Early surgical intervention is necessary for achieving early seizure control. Neither intraoperative ECoG nor IOUS necessarily leads to better seizure control, although the latter can be helpful in achieving complete tumor resection. Simple lesionectomy is sufficient for favorable postoperative seizure outcome.
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Acta neurochirurgica · May 2012
Surgical results of an endoscopic endonasal approach for clival chordomas.
The surgical approaches for clival chordomas remain controversial, although the extent of resection is one of the most important factors for long survival rates. Recently an endoscopic endonasal approach in good collaboration with otolaryngologists has attracted major attention as a surgical approach for clival chordomas. We describe our experience with the endoscopic endonasal approach and provide a review of the literature. ⋯ The endoscopic endonasal transclival approach allows an appropriate extent of resection with acceptable complication rates in comparison with other approaches. In our series, the accomplishment of gross total removal was associated with the relationship between the tumors and surrounding structures, such as the pituitary gland and the cavernous portion of the intracranial carotid artery (ICA).
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Acta neurochirurgica · May 2012
Percutaneous balloon compression for the treatment of trigeminal neuralgia in patients with multiple sclerosis. Analysis of the potentially prognostic factors.
The role of different procedures for the treatment of drug-resistant trigeminal neuralgia (TN) in patients affected by multiple sclerosis (MS) is under discussion and there are no clear indications in the literature. In particular, the role of percutaneous balloon compression (PBC) has been poorly addressed so far. Moreover, to the best of our knowledge, there are no reports analysing the factors potentially related to the prognosis in these patients. We examined the role of PBC for the treatment of TN in MS patients and investigated the role of some clinical and procedure-related factors in determining the prognosis of these patients. ⋯ PBC is a safe and effective technique to treat drug-resistant TN in MS patients. Some clinical and procedure-related factors may play a role in the prognosis of these patients.