Journal of neurosurgery
-
Journal of neurosurgery · Mar 2004
Multimodality image-guided surgery for the treatment of medically refractory epilepsy.
The aim of this study was to review seizure outcome, imaging modalities used, and complications following surgery in patients with epilepsy who had undergone multimodality image-guided surgery at our institution. ⋯ Multimodality image-guided surgery offers a new perspective in surgery for epilepsy. Functional imaging modalities previously lateralized and often localized a seizure focus, but did not provide enough anatomical information to resect the epileptogenic zone confidently and safely. The coregistration of these modalities to a volumetric MR image and their incorporation into an image-guided system has allowed surgeons to offer surgery to patients who may not previously have been considered eligible, with outcomes comparable to those in patients with more straightforward lesional epilepsy.
-
Journal of neurosurgery · Mar 2004
Randomized Controlled Trial Clinical TrialSuccessful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial.
The authors evaluated long-term clinical outcomes in selected acutely comatose patients with severe diffuse brain swelling and recent clinical signs of impending brain death who received a novel high-dose mannitol treatment compared with those who received conventional-dose mannitol in the emergency room. ⋯ Ultra-early high-dose mannitol administration in the emergency room is the first known treatment strategy significantly to reverse recent clinical signs of impending brain death, and also to contribute directly to improved long-term clinical outcomes for these patients who have previously been considered unsalvageable.
-
Journal of neurosurgery · Mar 2004
ReviewHigh cervical disc herniation presenting with C-2 radiculopathy. Case report and review of the literature.
The authors report the case of a 78-year-old man with a C2-3 disc herniation that had migrated rostrally, causing C-2 radiculopathy. The C-2 radiculopathy manifested immediately after the patient underwent placement of a ventriculoperitoneal shunt for normal-pressure hydrocephalus. ⋯ Postoperatively the patient's radiculopathy resolved completely. To the authors' knowledge, this is the first case of a C2-3 disc herniation manifesting as C-2 radiculopathy and treated via a posterior extradural approach.