Neurosurgery
-
Review Case Reports
Long-term remission of malignant brain tumors after intracranial infection: a report of four cases.
This report describes four patients with malignant brain tumors in whom regression or cure seems to be related to infection with bacteria. ⋯ The case histories presented in conjunction with the relevant literature reviewed support the concept that microbial infections may influence immune responses in brain tumor defense.
-
This study was conducted to determine whether removing the bony prominence located above the porus of the internal acoustic meatus, called the suprameatal tubercle, and surrounding bone using the retrosigmoid approach would aid in the exposure of tumors that are located predominantly in the cerebellopontine angle but that also extend into the middle cranial fossa in the region of Meckel's cave and thus avoid the need for a supratentorial craniotomy. ⋯ The suprameatal extension of the retrosigmoid approach will permit removal of some tumors that are located mainly in the posterior fossa but that extend into the middle fossa in the region of Meckel's cave. The exposure can be increased by opening the superior petrosal sinus as it crosses in the upper margin of the porus of Meckel's cave and by opening the tentorium lateral to Meckel's cave.
-
Obsessive-compulsive disorder is a common mental disorder, notorious for its chronicity and intractability. Stereotactic lesions within the anterior limb of the internal capsule have been shown to provide symptomatic relief in such refractory cases, but only few systematic evaluations have correlated anatomic lesion location with individual postoperative outcome. ⋯ The current anatomic long-term analysis after thermocapsulotomy or gamma knife capsulotomy for obsessive-compulsive disorder reveals common topographic features within the right-sided anterior limb of the internal capsule independent of treatment modality.
-
The goal of this study was to document the influence of the treatment method (early surgery versus early endovascular treatment) on the development of chronic shunt-dependent hydrocephalus in a series of 242 patients treated within 7 days after aneurysmal subarachnoid hemorrhage (SAH). ⋯ The results of the present study indicate that the treatment method used does not affect the risk of the later development of chronic shunt-dependent hydrocephalus (early surgery, 23.2% [29 of 125]; early endovascular treatment, 17.7% [11 of 62]; P = 0.45).
-
The goal of this study was to determine whether patients with "pure" epidural hematomas can now be transferred safely to a neurosurgical unit for decompression or whether general or orthopedic surgeons must still be prepared to perform emergency craniotomies. ⋯ Patients with pure epidural hematomas have better prognoses than previously assumed. There is usually enough time to safely transfer patients to a neurosurgical unit, provided that transport is rapid and anesthesiological services are available during the transport. Surgeons without training in neurosurgery should not perform emergency craniotomies in local hospitals but, rather, should transfer patients as quickly as possible to the nearest department of neurosurgery.