Neurosurgery
-
The optimal management of arteriovenous malformations (AVMs) in critical brain locations remains controversial. To reduce the risk of an AVM hemorrhage and to enhance the possibility of preserving neurological function, stereotactic radiosurgery was performed in 33 patients with newly diagnosed or residual AVMs located within the motor cortex. The role of embolization also was examined. ⋯ Stereotactic radiosurgery is a successful and safe management option for patients with motor cortex AVMs. The obliteration of AVMs and the attendant low morbidity rates indicate a primary role for radiosurgery in these patients. Staged radiosurgery may be necessary to increase obliteration rates for larger AVMs or for those that are not obliterated after the first procedure.
-
To introduce a method for a simple, nonexpansive laminoplasty that can be performed with a threadwire saw (T-saw) after en bloc laminotomy has been performed. The method can be applied along the entire spinal region, including the thoracic and lumbar spine. ⋯ Simple en bloc laminoplasty performed with a T-saw is a useful, safe procedure that can be used to reconstruct the posterior spinal elements throughout the whole spinal region after the intradural procedure has been performed.
-
Review Case Reports
Transcallosal resection of hypothalamic hamartomas, with control of seizures, in children with gelastic epilepsy.
Hypothalamic hamartomas (HHs) are associated with precocious puberty and gelastic epilepsy; the seizures are often refractory to antiepileptic medications and associated with delayed development and disturbed behavior. The current opinion is that surgery to treat intrahypothalamic lesions is formidable and that complete excision is not technically achievable. We report our experience with a transcallosal approach to the resection of HHs. ⋯ Complete or nearly complete resection of HHs can be safely achieved via a transcallosal approach, with the possibility of seizure freedom and neurobehavioral improvements.
-
Review Case Reports
Distal anterior choroidal artery aneurysm in a patient with moyamoya disease: case report.
Distal anterior choroidal artery (AChA) aneurysms in moyamoya disease are rare, with few surgically verified reported cases. ⋯ Direct surgery should be considered in cases of ruptured distal AChA aneurysms located in the periventricular or intraventricular regions.