Journal of neurosurgery
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Journal of neurosurgery · Apr 1999
Cervical laminectomy without fusion in patients with rheumatoid arthritis.
The authors performed a prospective study to determine whether cervical laminectomy without simultaneous fusion results in spinal instability. ⋯ The authors conclude that decompressive laminectomy in which the facet joints are preserved can be performed in the rheumatoid arthritis-affected cervical spine in selected patients in whom signs of cord compression are demonstrated, but in whom radiographic and preoperative signs of instability are not. Performing a simultaneous fusion procedure does not always appear necessary. Vertical translocation must be detected early, and if present, a C-1 laminectomy should be followed by occipitocervical fusion.
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The insula is one of the paralimbic structures and constitutes the invaginated portion of the cerebral cortex, forming the base of the sylvian fissure. The authors provide a detailed anatomical study of the insular region to assist in the process of conceptualizing a reliable surgical approach to allow for a successful course of surgery. ⋯ The topographic anatomy of the insular region is described in this article, and a practical terminology for gyral and sulcal patterns of surgical significance is presented. This study clarifies and supplements the information presently available to help develop a more coherent surgical concept.
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Journal of neurosurgery · Apr 1999
Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding.
During a 5-year period 317 patients presenting with aneurysmal subarachnoid hemorrhage were successfully treated by coil embolization within 30 days of hemorrhage. The authors followed patients to assess the stability of aneurysm occlusion and its longer-term efficacy in protecting patients against rebleeding. ⋯ Periodic follow-up angiography after coil embolization is recommended to identify aneurysm recurrence and those patients at a high risk of late rebleeding.