Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Dec 2011
Review Meta AnalysisDiagnostic performance of iodine-123-metaiodobenzylguanidine scintigraphy in differential diagnosis between Parkinson's disease and multiple-system atrophy: a systematic review and a meta-analysis.
This study was designed to review the diagnostic performance of iodine-123-metaiodobenzylguanidine (MIBG) scintigraphy in differential diagnosis between Parkinson's disease (PD) and multiple-system atrophy (MSA). ⋯ MIBG scintigraphy is an accurate test for PD detection and differential diagnosis between PD and MSA; this method shows high sensitivity and adequate specificity in this field. Nevertheless, possible causes of false negative and false positive findings should be considered when interpreting the scintigraphic results.
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Clin Neurol Neurosurg · Dec 2011
Facial motor evoked potentials in cerebellopontine angle surgery: technique, pitfalls and predictive value.
To obtain information on functional integrity of the facial nerve by transcranial electrical motor evoked potentials independent of nerve visualization and to improve prediction of postoperative function. ⋯ As an adjunct to intraoperative EMG, FMEP are superior in two respects, first in identifying pre-surgical latent nerve lesions and second in monitoring nerve integrity without direct nerve visualization. FMEP are highly reliable in predicting early and late postoperative function.
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Clin Neurol Neurosurg · Dec 2011
Case ReportsBilateral sphenoorbital hyperostotic meningiomas with proptosis and visual impairment: a therapeutic challenge. Report of three patients and review of the literature.
Bilateral hyperostotic sphenoorbital meningiomas are extremely uncommon. Due to extensive infiltration of the orbits and the frontotemporal skull base, often only a subtotal tumor resection is feasible. Thus far, no treatment algorithms have been suggested for this rare tumor entity. We report on the surgical management of 3 patients. ⋯ In bilateral hyperostotic sphenoorbital meningiomas we propose staged surgery when clinical and radiological progression is observed. Subtotal tumor resection with the aim of optic nerve decompression and subsequent orbital reconstruction provides satisfactory results. The most affected eye should be treated first. In case of additional cavernous sinus infiltration, focal radiation therapy can be considered.