Journal of neurological surgery. Part A, Central European neurosurgery
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J Neurol Surg A Cent Eur Neurosurg · Jan 2016
Review Meta AnalysisComparison between Minimally Invasive and Open Transforaminal Lumbar Interbody Fusion: A Meta-Analysis of Clinical Results and Safety Outcomes.
A meta-analysis comparing the efficacy and safety of minimally invasive and open transforaminal lumbar interbody fusion (TLIF) for degenerative lumbar diseases. ⋯ Although the clinical efficacy, risk of complications and fusion rate were comparable between the two procedures, minimally invasive TLIF resulted in less blood loss, lower follow-up VAS score, and shorter perioperative hospitalization relative to open TLIF.
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J Neurol Surg A Cent Eur Neurosurg · Jan 2016
Review Case ReportsHypertrophic Olivary Degeneration: A Neurosurgical Point of View.
Hypertrophic olivary degeneration (HOD) is a rare form of transsynaptic degeneration characterized by hypertrophy of the inferior olivary nucleus situated in the olivary body, part of the medulla oblongata, representing a major source of input to the cerebellum. HOD typically results from focal lesions interrupting connections from the inferior olive within the dentato-rubro-olivary pathway, a region also known as the triangle of Guillain-Mollaret (TGM) (red nucleus, inferior olivary nucleus, and contralateral dentate nucleus). Clinically, HOD presents classically as palatal tremor and can include dentatorubral tremor and/or ocular myoclonus. ⋯ HOD has been found to develop as a consequence of any injury that disrupts the TGM pathways (e.g., pontine cavernoma). These findings highlight the critical importance of a thorough knowledge of TGM anatomy to avoid secondary HOD. We present a patient who developed HOD secondary to resection of a tectal plate cavernous malformation and review the literature with an emphasis on the current knowledge of this disorder.
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J Neurol Surg A Cent Eur Neurosurg · Jul 2014
Review Case ReportsMinimally invasive lateral retroperitoneal corpectomy for treatment of focal thoracolumbar kyphotic deformity: case report and review of the literature.
Corpectomy is a frequently performed procedure for pathologies of the anterior spine including neoplasms, fractures, deformities, and osteomyelitis. Traditional approaches to the anterior thoracic spine and thoracolumbar junction are associated with significant perioperative pulmonary complications and morbidity. Posterior and posterolateral approaches minimize some of these complications but are somewhat limited in visualization of the anterior elements. ⋯ Minimally invasive lateral corpectomy is a safe and effective option for deformity correction. We discuss the relative advantages and disadvantages of this approach and review the relevant literature.
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J Neurol Surg A Cent Eur Neurosurg · May 2013
Review Case ReportsPitfalls in brain death diagnosis: a case report.
Although there are distinct guidelines in nearly all countries, a reliable secure assessment of brain death in cases with open head injury can be challenging. We present a case of a 32-year-old man with severe head injury after intracranial penetration of a grindstone fragment. As the injury led to destruction of nearly the whole greater wing of the right sphenoid bone and parts of the right orbit, the examination of brainstem reflexes and the confirmation of brain death was unfeasible. ⋯ Referring to the actual German guidelines, we had no legitimating indication for a cerebral angiography. Finally, the patient died of sepsis. We discuss the widening of the German guidelines in assessing brain death with the fast and low-risk method of cerebral computed tomography-angiography (CTA) to confirm diagnosis of brain death.
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J Neurol Surg A Cent Eur Neurosurg · Mar 2013
ReviewCranial base repair with combined vascularized nasal septal flap and autologous tissue graft following expanded endonasal endoscopic neurosurgery.
The expanded endonasal endoscopic approach provides excellent visualization and access to midline skull base lesions, albeit with a relatively high risk of postoperative cerebrospinal fluid (CSF) leakage. We present our experience with the expanded endonasal endoscopic approach to the skull base in an institution where, previously, a traditional transsphenoidal approach with a surgical microscope had been used. ⋯ The repair of skull base defects created during expanded endonasal endoscopic surgery is improved by use of a mucoperichondrial nasal septal flap combined with a layered autologous tissue graft. When CSF leakage occurs despite nasal septal flap closure, the site of the leakage may be easier to localize and repair.