Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Feb 2014
Case ReportsEmbolization of dural arteriovenous fistula of the anterior cranial fossa through the middle meningeal artery with Onyx.
Dural arteriovenous fistula (DAVF) of the anterior cranial fossa is usually treated by surgical disconnection or endovascular embolization via the ophthalmic artery. The middle meningeal artery is a rarely used approach. This study investigated the safety and efficacy of embolization of DAVF of the anterior cranial fossa with Onyx through the middle meningeal artery. ⋯ Embolization of DAVF of the anterior cranial fossa via the middle meningeal artery with Onyx is safe, effective, and a good choice for management of DAVF. More cases are needed to verify these findings.
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Clin Neurol Neurosurg · Feb 2014
Predictive value of fractional anisotropy of the arcuate fasciculus for the functional recovery of language after brain tumor resection: a preliminary study.
The arcuate fasciculus has been recognized as an important pathway for language processing. Brain tumors located in proximity to the fasciculus frequently cause preoperative language impairment, and in some cases, no language recovery occurs after tumor resection. No predictive value has been presented for possible postoperative language recovery after tumor resection. The aim of this study is to analyze the preoperative state of the arcuate fasciculus in the patients with brain tumor from the perspective of its usefulness as a predictive factor for postoperative recovery of language functions. ⋯ There was a positive relationship between preoperative increasing values of the FA of the left arcuate fasciculus and improvement of the postoperative total WAB score (p=0.0056), and the scores of the naming (p=0.018), reading (p=0.029), and writing subcategories (p=0.012) CONCLUSION: The preoperative increasing value of the FA of the arcuate fasciculus in the dominant hemisphere could be a predictor for postoperative language recovery following tumor resection. Meticulous procedure should be performed especially in the cases with higher FA of the arcuate fasciculus harboring high possibility of language recovery.
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Clin Neurol Neurosurg · Jan 2014
Low-dose intrathecal fluorescein and etiology-based graft choice in endoscopic endonasal closure of CSF leaks.
Skull base cerebrospinal fluid (CSF) leaks of various etiologies are increasingly repaired through the natural corridor using an endoscopic endonasal approach. Characteristics of the skull base defect significantly correlate with etiology, which should be ascertained to guide surgical management. The objectives of this study were to assess the long-term outcomes of patients that underwent endoscopic endonasal repair of CSF leak using low-dose intrathecal fluorescein (ITF) and an etiology-based algorithm for multi-layer graft closure. ⋯ Low-dose ITF is a safe and useful adjunct to endoscopic endonasal repair of CSF leaks with minimal complications and successful localization of the leak in approximately 80%. An etiology-based approach to graft choice and duration of lumbar drain placement in CSF leak repair may optimize closure rates.
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Clin Neurol Neurosurg · Jan 2014
Microsurgical clipping of intracranial aneurysms assisted by green indocyanine videoangiography (ICGV) and ultrasonic perivascular microflow probe measurement.
The purpose of this work is to assess the surgical and clinical outcome of intracranial aneurysm clipping performed combining the assistance of green indocyanine videoangiography (ICGV) and ultrasonic perivascular microflow probe. ⋯ With the limits of our small case series, our results testify that the presented approach may provide high exclusion rate in the treatment of cerebral aneurysm with very low morbidity in selected patients.