Journal of neurosurgery
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Journal of neurosurgery · Oct 2012
Case Reports Comparative StudyDistinctive flow pattern of wall shear stress and oscillatory shear index: similarity and dissimilarity in ruptured and unruptured cerebral aneurysm blebs.
The difference in the hemodynamics of wall shear stress (WSS) and oscillatory shear index (OSI) between ruptured and unruptured aneurysms is not well understood. The authors investigated the hemodynamic similarities and dissimilarities in ruptured and thin-walled unruptured aneurysm blebs. ⋯ Ruptured and unruptured blebs shared a distinctive pattern of low WSS and high OSI. The degree of WSS at the rupture site was significantly lower than in the unruptured thin-walled blebs.
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Journal of neurosurgery · Oct 2012
Comparative StudyEndoscopic approaches to the trigeminal nerve and clinical consideration for trigeminal schwannomas: a cadaveric study.
The course of the trigeminal nerve straddles multiple fossae and is known to be very complex. Comprehensive anatomical knowledge and skull base techniques are required for surgical management of trigeminal schwannomas. The aims of this study were to become familiar with the endoscopic anatomy of the trigeminal nerve and to develop a minimally invasive surgical strategy for the treatment of trigeminal schwannomas. ⋯ The 5 endoscopic approaches effectively followed the course of the trigeminal nerve with minimal invasiveness. These approaches could provide alternative options for the management of trigeminal schwannoma.
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Journal of neurosurgery · Oct 2012
ReviewThe role of decompressive craniectomy in cerebral venous sinus thrombosis.
Studies on the role of decompressive craniectomy for cerebral venous sinus thrombosis (CVST) in the literature are scanty. Randomized trials face a lot of drawbacks, including ethical issues. In this article the authors discuss their experience with this procedure for CVST and review the available literature. ⋯ Decompressive craniectomy in a selected cohort of patients had a good outcome in a majority of the patients: 26 of 34 in this study had a GOS score of 4 or 5. In this series, which is the largest in the available literature, the authors review their experience and recommend usage of this procedure in selected patients.
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Journal of neurosurgery · Oct 2012
ReviewDecompressive hemicraniectomy for malignant middle cerebral artery territory infarction: is life worth living?
Although decompressive hemicraniectomy has been shown to reduce death and improve functional outcome following malignant middle cerebral artery territory infarction, there is ongoing debate as to whether surgery should be routinely performed, considering the very high rates of disability and functional dependence in survivors. Through a systematic review of the literature, the authors sought to determine the outcome from a patient's perspective. ⋯ Despite high rates of physical disability and depression, the vast majority of patients are satisfied with life and do not regret having undergone surgery.