Acta neurochirurgica
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Acta neurochirurgica · Mar 2014
Transcranial segment of the trigeminal nerve: macro-/microscopic anatomical study using sheet plastination.
Trigeminal neuralgia (TN) may be caused by the mechanical compression of the trigeminal nerve. In the studies on the location of mechanical irritation and entrapment of the nerve, attention has been paid mostly to vascular structures in the subarachnoid space. Few studies have explored the relationship between the trigeminal nerve and its surrounding structures along its course in the skull base. The aim of this study was to examine and trace the root, ganglion and three divisions of the trigeminal nerve and their relationships with surrounding soft and bony structures in the skull base, and to identify the likely mechanical compression points. ⋯ This study identified four likely mechanical compression points along the course of the trigeminal nerve in the skull base. Knowledge of these TN-susceptible sites may be useful to both skull base surgeon and TN-animal model researcher, particularly when they study TN without vascular compression.
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Acta neurochirurgica · Mar 2014
Imaging investigation of intracranial arterial dissecting aneurysms by using 3 T high-resolution MRI and DSA: from the interventional neuroradiologists' view.
The purpose of this study was to investigate vessel wall imaging features combined with the luminal shapes of intracranial dissecting aneurysms (IDAs) by using 3 Tesla (3T) high-resolution magnetic resonance imaging (MRI) and digital subtraction angiography (DSA). ⋯ 3T high-resolution MRI combined with DSA offered clear visualization of vessel wall features and accurate assessment of the vessel lumen in IDAs. This combined approach would be highly useful for understanding the underlying pathological status of IDAs and in guiding treatment choices.
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Acta neurochirurgica · Mar 2014
Surgical complications after transsphenoidal microscopic and endoscopic surgery for pituitary adenoma: a consecutive series of 506 procedures.
This single-institution, consecutive series of transsphenoidal procedures included all patients in a defined population of 2.6 million inhabitants who underwent surgery during a specific time period. ⋯ Transsphenoidal surgery for pituitary adenomas has a low complication rate and a low rate of mortality. We did not find a significant difference in the complication rate between endoscopic and microscopic techniques.
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Acta neurochirurgica · Mar 2014
CT perfusion-derived mean transit time of cortical brain has a negative correlation with the plasma level of Nitric Oxide after subarachnoid hemorrhage.
Vasospasm of both large and small parenchymal arteries may contribute to the occurrence of delayed ischemic neurological deficits, and nitric oxide(NO) is an important mediators in the development of cerebral vasospasm after subarachnoid hemorrhage (SAH). We used a rabbit two-hemorrhage model to investigate changes in plasma NO after SAH, and the relationship between NO and brain microcirculation. ⋯ There was a significant correlation between the increase in MTT and the decrease in plasma NO (P < 0.05), We hypothesized that normalization of NO might have a positive influence on brain microcirculation following SAH.
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Acta neurochirurgica · Mar 2014
Fluorescence-guided surgery with 5-aminolevulinic acid for resection of brain tumors in children--a technical report.
5-aminolevulinic acid (5-ALA) can be used as an adjunct for the surgery of adult malignant glioma and improves the rate of gross total resection and patient survival. So far, only three casuistic reports of fluorescence-guided surgery used in children have been published. We report our pilot series of 16 pediatric brain tumors treated with 5-ALA. ⋯ Positive fluorescence was observed in two high-grade gliomas and one medulloblastoma after oral administration of 5-ALA. Thus, 5-ALA appears capable of inducing fluorescence in pediatric high-grade tumors. Adverse reactions observed in children were similar to those reported for adults, although very young children might be at increased risk. Further studies are required to elucidate pharmacokinetic and pharmacodynamic properties of 5-ALA in children and to assess its prognostic role in the resection of pediatric brain tumors.