Acta neurochirurgica
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Acta neurochirurgica · Aug 2010
The first 50s: can we achieve acceptable results in vestibular schwannoma surgery from the beginning?
Vestibular schwannoma surgery requires a profound knowledge of anatomy and long-standing experience of surgical skull base techniques, as patients nowadays requests high-quality results from any surgeon. This educes a dilemma for the young neurosurgeon as she/he is at the beginning of a learning curve. The presented series should prove if surgical results of young skull base surgeons are comparable respecting carefully planned educational steps. ⋯ The results demonstrate that with careful established educational plans in skull base surgery, excellent clinical and functional results can be achieved even by young neurosurgeons.
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Acta neurochirurgica · Jul 2010
Implementation of the European Working Time Directive in neurosurgery reduces continuity of care and training opportunities.
Implementation of the European Working Time Directive (EWTD) raises questions about reduced surgical training opportunities and lost continuity of patient care. We studied the effect that the EWTD has had in these areas for residents in the neurosurgical unit at St. George's Hospital, London, UK. ⋯ The EWTD has had a marked adverse impact on continuity of care for neurosurgical patients at St. George's Hospital. Residents' training opportunities were reduced.
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Acta neurochirurgica · Jul 2010
Case ReportsSynovial cyst that compressed the peroneal nerve: case report.
We report a case of synovial cyst that induced the compression of the peroneal nerve. The patient presented with foot drop and impossibility to stand on his right heel associated with numbness of anterolateral surfaces of the right shin and the dorsal surface of the foot within a 1-month period. Based on the clinical examination and electroneuromyography data, the compression of nerve by soft elastic mass was confirmed. ⋯ Histological study revealed the cyst of synovial membrane. During the postoperative period, a force in extensors of the right foot was restored. On the seventh day, the patient began to step on his right heel, while the zone of tenderness and temperature hypoesthesia in the area of the peroneal nerve innervation remained.
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Acta neurochirurgica · Jul 2010
Comparative StudyMagnetic resonance angiography, digital subtraction angiography and Doppler ultrasonography in detection of carotid artery stenosis: a comparison with findings from histological specimens.
Patients' life expectancy, clinical symptomatology and the extent of carotid stenosis are the most important factors when deciding whether to perform carotid endarterectomy (CEA) in patients with carotid stenosis. Therefore, the accuracy of measuring carotid stenosis is of utmost importance. ⋯ Our study confirms that DSA underestimates moderate and mild ICA stenosis. DUS slightly overestimated moderate ICA stenosis and highly overestimated high-grade ICA stenosis. MRA proved to be accurate in detecting moderate ICA stenosis, but slightly underestimated mild stenosis and overestimated high-grade stenosis. The surgeon should be aware of these discrepancies when deciding whether to perform CEA in patients with ICA stenosis.
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Acta neurochirurgica · Jul 2010
Case ReportsMonitoring of motor and somatosensory systems in a 26-week pregnant woman.
We report the case of a 34-year-old woman who was 26 weeks pregnant and needed a brain surgery. ⋯ Our findings suggest that IONM can be safely applied in pregnant women.