Neurosurgery
-
Case Reports
Endovascular treatment of giant intracranial aneurysms with willis covered stents: technical case report.
To evaluate the efficacy of endovascular treatment of giant intracranial aneurysms with Willis covered stents (Micro-Port, Shanghai, China). ⋯ The use of covered stents in intracranial vascular structures is a feasible method to treat selected cases of intracranial giant aneurysms. It is suggested that patients who present with compressive mass effect caused by large or giant aneurysms are the best candidates for covered stent placement, but potential complications should be considered carefully before the stenting procedure.
-
Patients with convexity and parasagittal (CPS) meningiomas treated with stereotactic radiosurgery (SRS) have been shown to be at risk for posttreatment symptomatic peritumoral edema (SPTE). We sought to analyze the pattern of this complication and compare it with the SPTE experienced in our patients treated with fractionated stereotactic radiotherapy. ⋯ Despite larger lesion volumes, fractionated stereotactic radiotherapy is associated with less risk of posttreatment SPTE than SRS for patients with CPS meningiomas in our series. For patients treated with SRS, smaller volume and dose <14 Gy seems to be safe. Longer follow-up will be required to compare late complications and tumor control rates in these patients.
-
Resection of the glenoid fossa has been described as part of cranial approaches to the clivus and subtemporal approaches. However, radical resection carries a significant risk of postoperative temporomandibular joint dysfunction. We examine a simple variation of our previously described one-piece frontotemporal orbitozygomatic (FTOZ) osteotomy that adds en bloc resection of the root of the zygomatic arch and a portion of the glenoid fossa. ⋯ In this cadaveric study, extension of the one-piece FTOZ approach included the posterior root of the zygoma and the lateral part of the glenoid fossa. En bloc resection of the glenoid fossa and root of the zygomatic arch, together with the FTOZ osteotomy, facilitated reconstruction of the temporomandibular joint and increased the amount of exposure obtained with this FTOZ osteotomy. Comprehensive understanding of functional outcomes awaits further clinical study.
-
To evaluate our initial experience with Novalis (BrainLAB, Heimstetten, Germany) frameless image-guided noninvasive radiosurgery. ⋯ This initial evaluation demonstrates the system accuracy and feasibility of Novalis image-guided noninvasive radiosurgery for intracranial benign and malignant lesions.
-
For patients with internal carotid artery occlusion with advanced narrowing of the ipsilateral external carotid artery (ECA), we performed preventive carotid endarterectomy (CEA) for the ECA stenosis before superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis for internal carotid artery occlusion. ⋯ The present study suggests that surgical management by external CEA followed by STA-MCA anastomosis is safe and effective for patients with internal carotid artery occlusion and advanced stenosis of the ipsilateral ECA.