World Neurosurg
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This report describes the technique for implanting a vagus nerve stimulator via a single low anterior cervical incision and discusses the advantages of this technique over that of the more commonly used 2-incision technique. ⋯ The single-incision technique described here for implantation of vagus nerve stimulators is technically straightforward and safe, and has significant advantages over the 2-incision technique.
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Comparative Study
Assessment of Cerebral Blood Flow Using Microdoppler Vascular Reduces the Risk of Ischemic Stroke during the Clipping of Intracranial Aneurysms.
To analyze the impact of the introduction of Micro-Doppler vascular (MDV) as a method of cerebral blood flow analysis during microsurgical clipping of intracranial aneurysms to check the partial occlusion of the aneurysm and the occurrence of stenosis by comparing these results with those provided by the postoperative digital subtraction angiography (DSA) scan as well as the occurrence of ischemic infarction on the postoperative computed tomography (CT) images. ⋯ MDV is an excellent method for cerebral blood flow assessment during the microsurgical clipping of intracranial aneurysms, reducing the unexpected angiographic results (residual aneurysms, stenosis, and arterial occlusion), as well as reducing the incidence of ischemic infarction on postoperative CT images, evidence of the positive impact of this method in the microsurgical treatment of intracranial aneurysms.
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This study aims to evaluate quantitatively the mechanical properties of meningiomas and their correlation with the qualitative surgeon's assessment of consistency, as well as comparing the capability to predict tumor consistency of fractional anisotropy values calculated from the diffusion tensor imaging and T1/T2 signal intensities. ⋯ Qualitative surgeon's assessment was in accordance with measured mechanical properties. Fractional anisotropy value was not an independent predictor for tumor consistency and was not correlated with the mechanical tests results. T1/T2 assessment was correlated with mechanical properties and it can be used to discriminate very hard or soft tumors.
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Case Reports
Surgical Management of Giant Intracranial Arteriovenous Malformations: A Single Center Experience over 32 years.
Treatment of giant intracranial arteriovenous malformations (gAVMs) is a formidable challenge for neurosurgeons and carries significant morbidity and mortality rates for patients compared with smaller AVMs. In this study, we reviewed the treatments, angiographic results, and clinical outcomes in 64 patients with gAVMs who were treated at Henry Ford Hospital between 1980 and 2012. ⋯ Treatment of gAVMs carries significant morbidity and mortality; however, good outcomes are attainable with a multimodal treatment approach in carefully selected patients.
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Shunted patients with idiopathic intracranial hypertension (IIH) often present to the emergency department (ED) for symptoms related to their disease. Although brain imaging with computed tomography (CT) is often performed, particularly in the current medicolegal environment, its utility during these ED visits is unclear. ⋯ In our cohort, CT imaging rarely showed a change in pathology or affected the management of patients with IIH. There was no difference in the rate of management changes between those patients who underwent a CT scan and those who did not. Given the risk of cumulative radiation exposure and cost of CT scans, CT imaging should be used when there is concern for visual dysfunction and the utility of CT imaging in the ED for the workup of other symptoms related to IIH must be explored further.