Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Review Case Reports
Intracavernous schwannoma of the abducens nerve: a review of the clinical features, radiology and pathology of an unusual case.
We report a case of an intracavernous abducens nerve schwannoma presenting in a 19 year old male of Mediterranean origin. This is only the second report of an abducens nerve schwannoma located entirely within the cavernous sinus. ⋯ A literature search has identified only four other abducens nerve schwannomas arising completely or partly within the cavernous sinus. We review these cases and aspects of other ocular cranial nerve schwannomas.
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Review
Intraoperative magnetic resonance imaging: considerations for the operating room of the future.
Recent technological advances have made possible the introduction of the magnetic resonance imaging (MRI) system into the operating room to guide neurosurgical interventions. We review the possibilities and limitations associated with various open-configuration magnet designs, including systems from the Phillips, Siemens, General Electric, Odin and IMRIS designs. This technology has been shown to be a feasible adjunct to current neurosurgical management of intracranial brain tumors for both biopsy and resection procedures and shows significant potential applications for epilepsy surgery, spine surgery and for minimally invasive interventional techniques. Combined with other surgical planning modalities, intra-operative MRI scanners provide an evolutionary influence on the design of today's operating room.
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The evidence for post-traumatic migraine as the cause of the postconcussion syndrome in a proportion of patients is reviewed. ⋯ patients suffering recurrent post-traumatic headaches or other elements of the postconcussion syndrome should be treated for migraine.
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Many investigators attribute the postconcussion syndrome following mild closed head injury to permanent brain damage. The evidence supporting this conclusion is reviewed, including the force necessary to cause permanent brain damage; the basis for determining whether the patient was exposed to sufficient force in the accident to permanently damage the brain; the basis for determining whether the patient actually has permanent brain damage (not just brain dysfunction) traceable to the accident; and whether the location and severity of brain damage is sufficient to account for the postconcussion syndrome. ⋯ the evidence for permanent traumatic brain damage as the cause of the postconcussion syndrome following mild closed head injury is weak.