Neurosurgery
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Case Reports
Intraoperative application of thermography in extracranial-intracranial bypass surgery.
The extracranial-intracranial bypass may have the potential to improve hemodynamic cerebral ischemia caused by occlusive diseases of the main cerebral arteries. Intraoperative confirmation of effective distribution of blood flow via the donor arteries to the involved region will assure a successful bypass surgery. ⋯ Thermography is useful not only to demonstrate the distribution of blood flow through the extracranial-intracranial bypass but also to quantitatively evaluate the rCBF changes in the operative field.
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Biography Historical Article
E. Latunde Odeku: the first African-American neurosurgeon trained in the United States.
The advances of the Civil Rights movement in the mid-20th century and the success of the first African-American neurosurgeons trained at the Montreal Neurological Institute have led to a number of African-Americans receiving neurosurgery training within the United States. Unfortunately, the details regarding the first African-American neurosurgeon trained in the United States, E. Latunde Odeku, have largely remained in obscurity. ⋯ C. S., enabled him to become the first African-American neurosurgeon trained in the United States. A truly global pioneer, his selfless service in America and Nigeria opened the door for people from each country to enhance the field of neurosurgery.
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Clinical Trial
Neuronavigation for arteriovenous malformation surgery by intraoperative three-dimensional ultrasound angiography.
Neuronavigational devices have traditionally used preoperative imaging with limited possibilities for adjustment to brain shift and intraoperative manipulation of the surgical lesions. We have used an intraoperative imaging and navigation system that uses navigation on intraoperatively acquired three-dimensional ultrasound data, as well as preoperatively acquired magnetic resonance imaging scans and magnetic resonance angiograms. The usefulness of this system for arteriovenous malformation (AVM) surgery was evaluated prospectively. ⋯ The complexities of handling the pathological vessels of AVMs were ameliorated by intraoperative three-dimensional ultrasound and navigation because the three-dimensional outline of the vasculature (feeders, nidus, and draining veins) provided a means to adapt resection strategies, define dissection planes, and interpret intraoperative findings. It is difficult to provide a scientifically valid definition of "added value." However, in our experience, the added confidence and the improved mental image of the lesion that resulted from this technology improved the quality and flow of surgery.
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Comparative Study
Percutaneous transforaminal lumbar interbody fusion for the treatment of degenerative lumbar instability.
Percutaneous spinal instrumentation techniques may be helpful to reduce approach-related morbidity inherent to conventional open surgery. This article reports technique, clinical outcomes, and fusion rates of percutaneous transforaminal lumbar interbody fixation (pTLIF). Results are compared with those of mini-open transforaminal lumbar interbody fixation (oTLIF) using a muscle splitting (Wiltse) approach. ⋯ pTLIF allows for safe and efficient minimally invasive treatment of single and multilevel degenerative lumbar instability with good clinical results. Further prospective studies investigating long-term functional results are required to assess the definitive merits of percutaneous instrumentation of the lumbar spine.
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This is a retrospective study of 18 patients harboring a solitary fibrous tumor of the central nervous system. Therapeutic management and outcome were analyzed. ⋯ Prognosis of solitary fibrous tumors of the central nervous system remains unclear; consequently, careful and close monitoring of patients and long-term follow-up are mandatory. Radical surgical excision seems to be a significant and reliable prognosis factor, although pathological prognostic features must be defined. In other respects, the role of postoperative radiotherapy in atypical or incompletely resected solitary fibrous tumors of the central nervous system remains to be determined and, therefore, warrants larger series with longer follow-up periods.