Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Dec 2011
A practical approach to the lateral cutaneous nerve of the thigh: an anatomical study.
To study the main anatomical landmarks related to the lateral cutaneous nerve of the thigh (LCN) in the infrainguinal region and to define reliable criteria for identifying the nerve during the surgery and electrophysiological study. ⋯ Despite the symmetry found between the right and left sides, the values of the main anatomic parameters involved in the localization of the LCN presented a great degree of variability. Even so, dissection using the proposed anatomical triangle allows for the localization of the LCN in almost all cases.
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Clin Neurol Neurosurg · Dec 2011
Case ReportsAnatomical studies on the temporal bridging veins with Dextroscope and its application in tumor surgery across the middle and posterior fossa.
To evaluate the application of virtual reality technology in neurosurgical anatomy we compared the virtual three-dimensional (3D) microanatomy of the temporal bridging veins as part of the resection of tumors across the petrosal crest in 25 patients against the actual microanatomy of the temporal bridging veins on 20 cadaveric head sets. ⋯ Virtual reality technology can accurately simulate the anatomical feature of the temporal bridging veins which facilitates the planning of individual operations in neurosurgery.
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Clin Neurol Neurosurg · Dec 2011
ReviewMicrovascular decompression surgery for trigeminal neuralgia and hemifacial spasm: naunces of the technique based on experiences with 100 patients and review of the literature.
Microvascular decompression (MVD) surgery for trigeminal neuralgia and hemifacial spasm offers a relatively low-risk opportunity to treat cranial nerve hyperactivity-compression syndromes, which are associated with severe, disabling facial pain and spasm. Although a number of publications have described the technique in detail, combining the technical nuances from different schools of thought or neurosurgical training in an effort to increase the safety and efficacy of this procedure would be beneficial to the surgeon. ⋯ In the presence of alternative methods of therapy, microvascular decompression operations should be performed with low risk to the patient. There is a learning curve involved with this operation and the surgeon should remain always critical of his/her performance and aspire for a "perfect" result.
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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
Temporal lobe pleomorphic xanthoastrocytoma and chronic epilepsy: long-term surgical outcomes.
To review clinical features and surgical outcome in patients with temporal lobe pleomorphic xanthoastrocytomas (PXAs) and intractable epilepsy. ⋯ Temporal lobe pleomorphic xanthoastrocytomas causing chronic intractable epilepsy occur in younger patients, and demonstrate excellent long-term results in seizure improvement and tumor control with surgery. We support the choice between simple lesionectomy and a tailored resection with amygdalohippocampectomy guided by preoperative findings, intraoperative electrocorticography, and the severity and chronicity of the patient's epilepsy.