Journal of neurosurgery
-
Journal of neurosurgery · Apr 2008
Outpatient brain tumor surgery: innovation in surgical neurooncology.
Recent studies of conventional craniotomies and image-guided biopsies have afforded a solid characterization of surgical morbidity and the timing of its occurrence. This report outlines a novel 11-year experience with outpatient image-guided biopsy and outpatient craniotomy for supratentorial intraaxial brain tumors. ⋯ Outpatient image-guided brain biopsy and outpatient craniotomy for tumor resection are safe and effective procedures in selected patients.
-
Journal of neurosurgery · Apr 2008
The vestibular aqueduct: site of origin of endolymphatic sac tumors.
Although endolymphatic sac tumors (ELSTs) frequently destroy the posterior petrous bone and cause hearing loss, the anatomical origin of these neoplasms is unknown. To determine the precise topographic origin of ELSTs, the authors analyzed the imaging, operative, and pathological findings in patients with von Hippel-Lindau disease (VHL) and ELSTs. ⋯ ELSTs originate from endolymphatic epithelium within the vestibular aqueduct. High-resolution imaging through the region of the vestibular aqueduct is essential for diagnosis. Surgical exploration of the endolymphatic duct and sac is required for complete resection.
-
Journal of neurosurgery · Apr 2008
Blood blister-like aneurysms of the internal carotid artery trunk causing subarachnoid hemorrhage: treatment and outcome.
The object of this study was to evaluate cases of subarachnoid hemorrhage (SAH) from ruptured blood blister-like aneurysms (BBAs) of the internal carotid artery (ICA) trunk. ⋯ Internal carotid BBAs are rare, small, and difficult to treat endovascularly, with only 2 of 14 patients successfully treated with coil placement. The BBAs rupture easily during surgery (ruptured in 6 of 11 surgical cases). Intraoperative aneurysm rupture invariably led to ICA trap ligation. Sacrifice of the ICA within 48 hours of an SAH led to very poor outcome, even in patients with adequate collateral capacity on preoperative angiograms, probably because of vasospasm-induced compromise of the cerebral collaterals.
-
Journal of neurosurgery · Apr 2008
Biography Historical ArticlePioneering Turkish neurosurgeon Hami Dilek and the traces of Harvey Cushing's legacy in his work.
Hami Dilek trained in neurosurgery under Clovis Vincent and Thierry de Martel, pioneers of French neurosurgery who ranked among Harvey Cushing's most loyal admirers. Taking cues from Cushing and the giants of French neurosurgery, Dilek became the first surgeon to practice neurosurgery regularly in Turkey during the 1930s. In 1949, Dilek founded the first independent Turkish department of neurosurgery in Istanbul, and in 1951 he initiated resident training in neurosurgery. ⋯ Also, they both single-handedly developed a new specialty where one did not exist before. Further similarities between Dilek and Cushing are also revealed in Dilek's delightful surgical and anatomical drawings. Dilek played an important role in the establishment and development of modern Turkish neurosurgery, and his life story highlights the fact that Cushing's legacy strongly influenced Turkish neurosurgery in the first half of the 20th century.