Acta neurochirurgica
-
Acta neurochirurgica · Feb 2011
Review Case ReportsMicrosurgical treatment of temporal lobe cavernomas.
Cavernomas of the temporal lobe occur in 10-20% of patients with cerebral cavernomas. They frequently cause epileptic seizures, some of which tend to become refractory to medical therapy. Surgical removal of safely achievable symptomatic lesions has been frequently consistent with good long-term outcome. In the present study, a postoperative outcome is assessed. ⋯ Microsurgical removal of temporal lobe cavernomas is a safe and effective method to improve seizure outcome in patients with medically intractable epilepsy and to prevent deterioration caused by hemorrhage.
-
Acta neurochirurgica · Feb 2011
Review Case ReportsCauses of neurological deficits following clipping of 200 consecutive ruptured aneurysms in patients with good-grade aneurysmal subarachnoid haemorrhage.
The surgical risk of unruptured aneurysms is well quantified. Although the outcomes for ruptured aneurysms are also well described, due to the concurrent morbidity from the natural history of the haemorrhage, the relative contributions of surgery and natural history to outcome following aneurysmal subarachnoid haemorrhage (SAH) is not. Our aim was to quantify these risks. ⋯ Overall, surgically treated good-grade SAH has a good outcome. The majority of poor outcomes are due to surgical complications and most of these are vascular. Careful preservation of perforators and accurate clip placement remain the key factors in determining outcome in surgically treated good-grade SAH.
-
Acta neurochirurgica · Dec 2010
Review Case ReportsHead positioning and risk of pneumocephalus, air embolism, and hemorrhage during subthalamic deep brain stimulation surgery.
The objective of the present study was to evaluate the risk of pneumocephalus, venous air embolism (VAE), and intracranial hemorrhage in subthalamic nucleus (STN) deep brain stimulation (DBS) patients operated in the strict supine (head and body flat) position. ⋯ Our data suggest that strict supine positioning during STN DBS surgery results in minimal intracranial air and is not associated with VAE or symptomatic intracranial hemorrhage when the operative method described is used.
-
Acta neurochirurgica · Dec 2010
ReviewSurgical and hardware complications of deep brain stimulation. A seven-year experience and review of the literature.
Deep brain stimulation (DBS) has been established as a safe and efficient method for the treatment of various movement disorders. As the emerging applications continue to expand and more centers become eligible for the procedure, complication rates and complication avoidance become increasingly important. Our aim was to report the DBS-related complication in our department over the last 7 years, compare our rates with those reported in the literature, and highlight those practices that will aid complications avoidance. ⋯ Complication rates after DBS surgery remain low, proving that DBS is not only effective but also safe. Certain strategies do exist in order to minimize complications.
-
Acta neurochirurgica · Aug 2010
Review Case ReportsAcute intracranial hypertension and shunt dependency following treatment of intracranial arachnoid cyst in a child: a case report and review of the literature.
Arachnoid cysts are developmental anomalies that represent 1% of all intracranial space occupying lesions. Treatment of symptomatic cases may include shunting of the cyst or an open fenestration of it, among other less acceptable surgical procedures. ⋯ We present a case of the development of an acute intracranial hypertension during cysto-peritoneal shunt malfunction in a child. We describe the possible mechanism of these phenomena and, based on this report and by reviewing other case series in the literature, we raise the possibility that acute increase in intracranial pressure and the development of shunt dependency, although rare, are important complications of shunting an arachnoid cyst.