Acta neurochirurgica
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Acta neurochirurgica · Feb 2017
Observational StudyThe value of short-term pain relief in predicting the 1-month outcome of 'indirect' cervical epidural steroid injections.
Clinical management after epidural steroid injections (ESI) of patients with radiculopathy secondary to a cervical disc herniation (CDH) is uncertain. This study aims to determine whether short-term arm pain alleviation following computed tomography-guided 'indirect' cervical ESI can predict the 1-month outcome. ⋯ The results of this study can guide physicians in managing patients with CDH: a ≤50 % arm pain relief within 1 week after an 'indirect' cervical ESI predicts an unfavorable 1-month outcome and suggests that other treatment options may be considered at an earlier point in time.
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Acta neurochirurgica · Feb 2017
Failed microvascular decompression surgery for hemifacial spasm: a retrospective clinical study of reoperations.
To investigate the repeat microvascular decompression on hemifacial spasm patients who failed the first MVD. ⋯ We suggested that repeat MVD can be performed 2 years after the first MVD if the spasm was not resolved. Repeat MVD for HFS is effective.
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Acta neurochirurgica · Feb 2017
Fluorescein sodium-guided resection of cerebral metastases-an update.
Cerebral metastasis (CM) is the most common malignancy affecting the brain. In patients eligible for surgery, complete tumor removal is the most important predictor of overall survival and neurological outcome. The emergence of surgical microscopes fitted with a fluorescein-specific filter have facilitated fluorescein-guided microsurgery and identification of tumor tissue. In 2012, we started evaluating fluorescein (FL) with the dedicated microscope filter in cerebral metastases (CM). After describing the treatment results of our first 30 patients, we now retrospectively report on 95 patients. ⋯ FL and the YELLOW 560-nm filter are safe and feasible tools for increasing the EOR in patients with CM. Further prospective evaluation of the FL-guided technique in CM-surgery is in planning.
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Acta neurochirurgica · Jan 2017
Surgical treatment of long-standing overt ventriculomegaly in adults (LOVA).
Longstanding overt ventriculomegaly in adults (LOVA) is characterised by chronic hydrocephalus presumed to begin during infancy, but arresting before becoming clinically detectable. Later in life clinical features of hydrocephalus ensue, typically in the 5th or 6th decades. Only a relatively small number of LOVA case series have been published, and ambiguity remains regarding optimal management. This case series describes a series of patients with LOVA treated successfully at a single neurosurgical institution using endoscopic third ventriculostomy (ETV). ⋯ ETV is an attractive option for surgical treatment of LOVA. After surgical treatment for LOVA, long-term follow-up should be considered to screen for late recurrence of the condition.
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Acta neurochirurgica · Jan 2017
Stent-assisted coiling embolization of tiny, wide-necked intracranial aneurysms.
Tiny, wide-necked intracranial aneurysms pose a significant therapeutic challenge for interventional neuroradiologists because of the small volume for microcatheterization and coil stabilization inside the aneurysm sac. We report our preliminary experience of stent-assisted coiling embolization of these aneurysms. ⋯ Stent-assisted coiling embolization is feasible and relatively safe for tiny, wide-necked intracranial aneurysms of carotid arteries. Furthermore, long-term follow-up angiography indicated stent-assisted coiling seems to be effective in preventing early recanalization.