Neurosurgical review
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Neurosurgical review · Jul 2009
Editorial Review Biography Historical ArticleWhat does Al-Qanun Fi Al-Tibb (the Canon of Medicine) say on head injuries?
A historical approach could help in the detection of some viewpoints that cannot be paid attention to or signified by a purely medical one. In this text, the important points of Ibn Sina's (Avicenna) treatise on head injuries have been introduced in light of neurosurgery. ⋯ Ibn Sina provided extremely systematic knowledge on head traumas along with both his observations and experiences and citations from the writings of the ancient physicians, Galen and Paul of Aegina. Regarding the treatment of skull fractures, Ibn Sina is a real successor of Galen and Paul of Aegina.
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Neurosurgical review · Jul 2009
ReviewDendritic-cell- and peptide-based vaccination strategies for glioma.
Despite advances in radiation and chemotherapy along with surgical resectioning, the prognosis of patients with malignant glioma is poor. Therefore, the development of a new treatment modality is extremely important. There are increasing reports demonstrating that systemic immunotherapy using dendritic cells and peptide is capable of inducing an antiglioma response. ⋯ Dendritic cell- and peptide-based therapy of glioma seems to be safe and without major side effects. There are several types of glioma; so to achieve effective therapy, it may be necessary to evaluate the molecular genetic abnormalities in individual patient tumors and design novel immunotherapeutic strategies based on the pharmacogenomic findings. Here, in this review, recent advances in dendritic-cell- and peptide-based immunotherapy approaches for patients with gliomas are discussed.
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Neurosurgical review · Apr 2009
Review Case ReportsSymptomatic vertebral artery conflicts to the medulla oblongata and microsurgical treatment options: review of the literature.
Symptomatic vascular compression of the medulla oblongata causing brainstem dysfunction is extremely rare. Only a few case reports documenting the clinical condition of patients, diagnostic features and therapeutic options are available in literature. The Medline search revealed with the present cases a total of 9 reports on patients with symptomatic vertebral artery compression to the brainstem. ⋯ The history, diagnostic features, microsurgical treatment and outcome of these patients are described in detail. As a conclusion these cases demonstrated that careful examination can serve to determine the diagnosis even in the young population microsurgical treated successfully. In conclusion the present review tries to provide an overview of the existent data on the variety of clinical, radiological and surgical features in patients with symptomatic vascular brainstem compression.
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Neurosurgical review · Jul 2008
Review Historical ArticleHistorical trends of neuroendoscopic surgical techniques in the treatment of hydrocephalus.
The treatment of hydrocephalus nowadays is still a challenge for neurosurgery. Neuroendoscopy is a valuable alternative of the CSF shunts in hydrocephalus management. ⋯ The historical milestones and state of the art of neuroendoscopic treatment of hydrocephalus are reviewed for each of its surgical techniques: choroid plexus coagulation, third ventriculostomy, aqueductoplasty, septostomy, foraminal plasty of the foramen of Monro, and foraminal plasty of the foramen of Magendie. The future trends of neuroendoscopic treatment of hydrocephalus such as robotics, image-guided neuroendoscopic surgical techniques, treatment "in utero", application of stem cell therapy, implementation of new technological solutions, and so on are discussed in the light of the approaching end of the century of neuroendoscopy.
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Literature suggest that hypertonic saline (HTS) solution with sodium chloride concentration greater than the physiologic 0.9% can be useful in controlling elevated intracranial pressure (ICP) and as a resuscitative agent in multiple settings including traumatic brain injury (TBI). In this review, we discuss HTS mechanisms of action, adverse effects, and current clinical studies. Studies show that HTS administered during the resuscitation of patients with a TBI improves neurological outcome. ⋯ In regards to control of elevated ICP during the inpatient course, HTS appears safe and effective. Although clinicians currently use HTS with some success, significant questions remain as to the dose and manner of HTS infusion. Direct protocol comparisons should be performed to improve and standardize patient care.