Acta neurochirurgica
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Acta neurochirurgica · Dec 2018
Case ReportsUnstable impedance of a single electrode contact resulting in loss of DBS therapy-a case report.
Open and short circuits of electrode contacts are important technical dysfunctions of DBS. Here, we report on another type of dysfunction restricted to a single electrode contact: impedance instability within regular absolute values. ⋯ During 3-year-follow-up, impedances of the dysfunctional contact varied between 1 and 3 kΩ whereas the other three contacts remained stable. Impedance documentation is crucial to identify such dysfunctions.
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Acta neurochirurgica · Dec 2018
How I do it: percutaneous transforaminal endoscopic discectomy for lumbar disk herniation.
Percutaneous transforaminal endoscopic discectomy (PTED) has emerged as a less invasive technique to treat symptomatic lumbar disk herniation (LDH). PTED is performed under local anesthesia with the advantage of immediate intraoperative feedback of the patient. In this paper, the technique is described as conducted in our hospital. ⋯ PTED seems a promising alternative to conventional discectomy in patients with LDH and can be performed safely.
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Acta neurochirurgica · Dec 2018
Review Meta AnalysisRadiosurgery and fractionated radiotherapy for cavernous sinus meningioma: a systematic review and meta-analysis.
Radiosurgery (RS) and fractionated radiotherapy (FRT) are part of the therapeutic armamentarium for the management of cavernous sinus meningiomas. We propose a systematic review of the local tumor control and clinical outcomes after monofractionated radiosurgical treatment, including gamma knife radiosurgery (GKRS) and linear accelerator (Linac RS), or fractionated radiotherapy. ⋯ RS achieved a twice-higher rate of tumor volume regression than FRT. GKRS series reported an improvement in visual acuity in 21% of the cases. GKRS, Linac, and FRT provided similar clinical post therapeutic outcomes for the trigeminal and oculomotor CN.
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Acta neurochirurgica · Dec 2018
External validation of cerebral aneurysm rupture probability model with data from two patient cohorts.
For a treatment decision of unruptured cerebral aneurysms, physicians and patients need to weigh the risk of treatment against the risk of hemorrhagic stroke caused by aneurysm rupture. The aim of this study was to externally evaluate a recently developed statistical aneurysm rupture probability model, which could potentially support such treatment decisions. ⋯ The model's performance measures indicated a good generalizability for data acquired at different clinical institutions. Combining the model-based and similarity-based approach could further improve the assessment and interpretation of new cases, demonstrating its potential use for clinical risk assessment.
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Acta neurochirurgica · Dec 2018
Frameless robot-assisted stereoelectroencephalography for refractory epilepsy in pediatric patients: accuracy, usefulness, and technical issues.
Stereoelectroencephalography (SEEG) is an effective technique to help to locate and to delimit the epileptogenic area and/or to define relationships with functional cortical areas. We intend to describe the surgical technique and verify the accuracy, safety, and effectiveness of robot-assisted SEEG in a newly created SEEG program in a pediatric center. We focus on the technical difficulties encountered at the early stages of this program. ⋯ SEEG has been useful for decision-making in all our pediatric patients. The robotic arm is an accurate tool for the insertion of the deep electrodes. Nevertheless, it is an invasive technique not risk-free and many problems can appear at the beginning of a robotic arm-assisted SEEG program that must be taken into account beforehand.