Surg Neurol
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Hydrocephalus associated with intracranial germ cell tumors or disseminated medulloblastoma has been treated with ventriculoperitoneal shunt. However, this procedure has a potential risk of intraperitoneal metastasis of these brain tumors. To prevent this potential risk and to minimize the risk of infection, we developed a percutaneous long-tunneled ventricular drainage (PLTVD). To confirm the effectiveness, we retrospectively analyzed the results of this procedure. ⋯ Percutaneous long-tunneled ventricular drainage was an effective method to manage long-lasting obstructive or communicating hydrocephalus with germ cell tumors and medulloblastoma.
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Clinical Trial
Size and location of ruptured and unruptured intracranial aneurysms measured by 3-dimensional rotational angiography.
The aim of the study was to report about accurate size and location of a consecutive series of ruptured and unruptured aneurysms taking the complex 3-dimensional (3D) anatomy and parent vessel morphology into consideration by using the newly developed 3D rotational angiography (3D-RA). ⋯ An automated calibration procedure applied to all images and excellent visualization of aneurysm and parent vessel morphology using 3D-RA allow accurate size measurement of intracranial aneurysms which may be smaller than previously thought. Small aneurysm (<7 mm), also in the anterior circulation, should be carefully evaluated for treatment.
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Comparative Study
Head injuries in adolescents in Taiwan: a comparison between urban and rural groups.
Data pertaining to head injuries in adolescents in Taiwan are scarce. The purpose of this study was to investigate the trend and pattern of head injuries in adolescents in both urban and rural areas in Taiwan. ⋯ The causes, patterns, and outcomes of head injury were statistically different between the 2 age groups of adolescents in urban and rural areas. Further studies on adolescent head injury are necessary.
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We report our experience with keyhole approaches as favorable treatments for various intracranial aneurysms including multiple aneurysms and giant aneurysms. ⋯ The keyhole approaches, based on improvements in diagnostic imaging, advanced surgical instruments, and microsurgical skills, are effective and ideal craniotomy techniques in the hands of experienced neurosurgeons for the treatment of intracranial aneurysms, including multiple and giant aneurysms, in patients without diffuse SAH, severe cerebral vasospasm, and severe brain edema or brain swelling.
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Parasagittal meningioma is one that fills the parasagittal angle, with no brain tissue between the tumor and the SSS. Invasion of the SSS is a challenge for complete removal and, consequently, for recurrence of these tumors. The objective of this study was to analyze the factors that influenced the clinical outcome of patients with parasagittal tumors surgically treated. ⋯ Recurrence of parasagittal meningiomas predominated in males, in grades II/III tumors, after subtotal resection, and with more invasion of the SSS. Subtotal or total resections without sinus resection were considered adequate for treating these patients.