Neurosurgery
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Multicenter Study Clinical Trial
Gamma knife thalamotomy for Parkinson disease and essential tremor: a prospective multicenter study.
No prospective study of gamma knife thalamotomy for intractable tremor has previously been reported. ⋯ GK thalamotomy is an alternative treatment for intractable tremors of PD as well as for ET. Less invasive intervention may be beneficial to patients.
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Multicenter Study
The silk flow-diverting stent in the endovascular treatment of complex intracranial aneurysms: technical aspects and midterm results in 24 consecutive patients.
The flow-diverting stent is a new option in endovascular therapy specifically designed for the endovascular reconstruction of a segmentally diseased artery. The safety of flow-diverting stents is still equivocal. ⋯ Many previously untreatable cerebral aneurysms may be successfully treated with the Silk flow-diverting stent, but the associated risk of thromboembolic events is justifiable only if conventional endovascular or surgical treatment options are not applicable. Perioperative thromboembolic events should be prepared for and treated without unnecessary delays because they frequently respond to adjunctive medical therapy.
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The relation of the pelvis to the spine has previously been overlooked as a contributor to sagittal balance. However, it is now recognized that spinopelvic alignment is important to maintain an energy-efficient posture in normal and disease states. The pelvis is characterized by an important anatomic landmark, the pelvic incidence (PI). ⋯ Sagittal balance, pelvic incidence, and all spinopelvic parameters are easily and reliably measured on standing, full-spine (lateral) radiographs, and it is essential to accurately assess and measure these sagittal values to understand their potential role in the disease process, and to promote spinopelvic balance at surgery. In this article, we provide a comprehensive review of the literature regarding the implications of abnormal spinopelvic parameters and discuss surgical strategies for correction of sagittal balance. Additionally, the authors rate and critique the quality of the literature cited in a systematic review approach to give the reader an estimate of the veracity of the conclusions reached from these reports.
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Review Case Reports
Trigeminal schwannomas: skull base approaches and operative results in 105 patients.
Trigeminal schwannomas make up 0.8% to 8% of all intracranial schwannomas. ⋯ The present series demonstrates acceptable results using microsurgical treatment to remove trigeminal schwannomas. Pain and diplopia may be relieved after surgery; however, hypesthesia frequently remains or may be worsened by surgery.
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Review
Carotid endarterectomy with primary closure: analysis of outcomes and review of the literature.
Despite abundant published support of patch angioplasty during carotid endarterectomy (CEA), primary closure is still widely used. The reasons underlying the persistence of primary closure are not quite evident in the literature. ⋯ In conjunction with contemporary medical management, primary closure during CEA may yield results comparable or superior to patch angioplasty. Advantages of primary closure include shorter cross-clamp times and elimination of graft-specific complications.