Journal of neurosurgery
-
Journal of neurosurgery · Jan 2007
ReviewPediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement.
The current treatment of craniopharyngiomas is evolving into one of a multimodal approach in which the aim is disease control and improved preservation of quality of life (QOL). To date, an appropriate classification system with which to individualize treatment is absent. The objectives of this study were to identify preoperative prognostic factors in patients with craniopharyngiomas and to develop a risk-based treatment algorithm. ⋯ For many children with craniopharyngiomas, the cost of resection is hypothalamic dysfunction and a poor QOL. By using a preoperative classification system to grade hypothalamic involvement and stratify treatment, the authors were able to minimize devastating morbidity. This was achieved by identifying subgroups in which complete resection or STR, performed by an experienced craniopharyngioma surgeon and with postoperative radiotherapy when necessary, yielded better overall results than the traditional GTR.
-
Journal of neurosurgery · Jan 2007
Neuroendoscopic treatment of multiloculated hydrocephalus in children.
The authors performed a retrospective analysis of data obtained in a series of 30 patients suffering from multiloculated hydrocephalus and treated endoscopically. The goal of the study was to evaluate the effectiveness of neuroendoscopic treatment as an alternative to the placement of multiple shunts to relieve intracranial hypertension, to simplify the shunt system, and to reduce the high rate of shunt revision. ⋯ Neuroendoscopic procedures are a valid alternative to shunt revision in the management of multiloculated hydrocephalus. Early diagnosis comprising close monitoring with high-resolution magnetic resonance imaging and early treatment are the keys of success.
-
Journal of neurosurgery · Jan 2007
Case ReportsVisualization of the frontotemporal language fibers by tractography combined with functional magnetic resonance imaging and magnetoencephalography.
There is continuous interest in the monitoring of language function during tumor resection around the frontotemporal regions of the dominant hemisphere. The aim of this study was to visualize language-related subcortical connections, such as the arcuate fasciculus (AF) by diffusion tensor (DT) imaging-based tractography. ⋯ The combination of these techniques facilitated accurate identification of the location of the AF and verification of the language fibers.
-
Journal of neurosurgery · Jan 2007
Multicenter Study Clinical TrialSafety and efficacy of a novel polyethylene glycol hydrogel sealant for watertight dural repair.
The authors prospectively evaluated the safety and efficacy of a novel polyethylene glycol (PEG) hydrogel sealant in patients undergoing elective cranial surgery with documented cerebrospinal fluid (CSF) leakage after sutured dural repair. ⋯ The PEG hydrogel sealant provides a safe and effective watertight closure when used as an adjunct to sutured dural repair during cranial surgery.