Journal of neurosurgery
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The authors conducted a study to record more detailed information about the natural course and factors predictive of outcome following gamma knife surgery (GKS) for cavernous hemangiomas. ⋯ Gamma knife surgery of cavernous hemangiomas can produce an acceptable rate of morbidity, which can be reduced by using a lower margin dose. Lesion regression was observed in many patients. Radiosurgery seems to remain a suitable treatment modality in carefully selected patients.
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Journal of neurosurgery · Jan 2005
Computational model for the estimation of the extracranial doses received during Leksell gamma knife model C treatment.
Extracranial doses received by patients undergoing Leksell gamma knife surgery (GKS) can be of clinical concern. Therefore, the ability to preestimate peripheral doses received outside the treatment field during the GKS would be beneficial and could be used for the optimization of treatment planning by providing a reference for practitioners to calculate the extracranial dose burden to the body before the start of treatment. ⋯ The peripheral dose depended on the collimator size with a logarithmic dependence on collimator size and a linear dependence on the number of shots. This model can be used for the estimation of peripheral doses with a total error less than 20%. This information can help clinicians with treatment planning optimization, especially in patients with long survival expectancy.
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Journal of neurosurgery · Jan 2005
Case ReportsPosterior cervical approach for intrathecal baclofen pump insertion in children with previous spinal fusions. Technical note.
Intrathecal baclofen pumps for the management of severe spasticity are being used more often in children with cerebral palsy. The intrathecal catheter is traditionally introduced dorsally in the lumbar region. In some children with previous thoracolumbar fusions for scoliosis, the fusion mass obviates the introduction of the intrathecal catheter. ⋯ Insertion was successful in all three patients; no complications of catheter disconnection, catheter dislodgment, or cerebrospinal fluid leakage occurred. Follow-up review ranged from 10 to 28 months postoperatively (mean 17 months). The posterior cervical approach for intrathecal baclofen pump insertion is a safe and effective alternative for patients who have previously undergone thoracolumbar spine fusions and in whom the traditional lumbar approach is not feasible.
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Journal of neurosurgery · Jan 2005
Initial experience with gamma knife surgery for endocrine ophthalmopathy.
The aim of this study was to evaluate both the effectiveness and safety of the treatment of endocrine ophthalmopathy with gamma knife surgery (GKS). ⋯ In light of the results obtained the authors consider that GKS may be a safe and effective way to treat endocrine ophthalmopathy.
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Journal of neurosurgery · Jan 2005
The combined use of hydroxyapatite and bioresorbable plates to repair cranial defects in children.
Hydroxyapatite cement (HAC) is used with increasing frequency by craniofacial surgeons for building facial and skull base structures and by neurosurgeons for cranioplasty. Failures of HAC in cranioplasty have been attributed to breakage due to subjacent cerebrospinal fluid (CSF) pulsations through the dura mater. The authors describe a technique that involves inserting a resorbable MacroPore perforated plate to dampen CSF pulsations and then pouring HAC over the plate to fill a cranial defect and complete skull contouring. ⋯ The findings of this study are promising and indicate that the combined use of HAC and a bioresorbable undercarriage that is osteoconductive, such as the MacroPore perforated plate, may produce a versatile and lasting cranioplasty in children.