Journal of neurosurgery
-
Journal of neurosurgery · Jun 2015
Neurological morbidity and mortality associated with the endovascular treatment of cerebral arteriovenous malformations before and during the Onyx era.
The widespread implementation of the embolic agent Onyx has changed the endovascular management of cerebral arteriovenous malformations (AVMs). Recent data suggest that outcomes following embolization and resection may have worsened in the Onyx era. It has been hypothesized that there may be increased complications with Onyx embolization and increased surgical aggressiveness in patients treated with Onyx. In this study the authors analyzed their institutional experience with the endovascular treatment of cerebral AVMs prior to and after the introduction of Onyx to determine factors associated with periprocedural neurological morbidity and mortality. ⋯ Permanent and transient postprocedural neurological deficits were noted in 9.6% and 1.8% of all cases, respectively. AVM grade was not associated with endovascular outcome. Despite the greater number of sessions required and arteries embolized for Onyx cases, there was no statistically significant difference in the risk of neurological deficits following cerebral AVM embolization with Onyx and NBCA.
-
Journal of neurosurgery · Jun 2015
Case ReportsSubtemporal transtentorial approach for recurrent trigeminal neuralgia after microvascular decompression via the lateral suboccipital approach: case report.
Microvascular decompression (MVD) via lateral suboccipital craniotomy is the standard surgical intervention for trigeminal neuralgia (TN). For recurrent TN, difficulties are sometimes encountered when performing reoperation via the same approach because of adhesions and prosthetic materials used in the previous surgery. In the present case report the authors describe the efficacy of the subtemporal transtentorial approach for use in recurrent TN after MVD via the lateral suboccipital approach. ⋯ Her TN disappeared after the MVD. The present approach is ideal for visualizing the trigeminal root entry zone, and the neurovascular complex can be easily dissected using a new surgical trajectory. This approach could be another surgical option for reoperation when the previous MVD had been performed via the suboccipital approach.
-
Journal of neurosurgery · Jun 2015
The anatomy of Meyer's loop revisited: changing the anatomical paradigm of the temporal loop based on evidence from fiber microdissection.
The goal in this study was to explore and further refine comprehension of the anatomical features of the temporal loop, known as Meyer's loop. ⋯ The fiber microdissection technique provides clear evidence that a loop in the anterior temporal region exists, but that this temporal loop is not formed exclusively by the optic radiation. Various projection fibers of the IC-SL, of which the optic radiation is only one of the several components, display this common course. The inherent limitations of the fiber dissection technique preclude accurate differentiation among individual fibers of the temporal loop, such as the optic radiation fibers.
-
The purpose of this study was to determine the minimum amount of nerve fibers required to maintain normal motor function after nerve injury in rats. ⋯ In this study of rodents, less than half of the motor axons were sufficient to maintain normal motor function of the lower limb.