Acta neurochirurgica. Supplement
-
The extradural space is currently investigated through fluoroscopy and ultrasound for surgical approach, whereas magnetic resonance imaging has been used to provide detailed information. The aim of the present paper is to describe the radiologic anatomy of the sacral canal through a review of its appearance in the different radiologic techniques. CT is able to visualise also the sacrum and the content of the sacral canal, triangular in shape in the transverse images, being able to establish the measurement of the transverse area of the dural sac and of the canal diameter. ⋯ The band-like structure on top is the sacrococcygeal ligament. The band-like structure at the bottom is the dorsal surface of the sacrum. The sacral hiatus corresponds to the hypoechoic region observed between the two hyperechoic band-like structures.
-
Acta Neurochir. Suppl. · Jan 2011
ReviewComparison of different preclinical models of intracerebral hemorrhage.
Intracerebral hemorrhage (ICH) is the most devastating type of stroke. It is characterized by spontaneous bleeding in brain parenchyma and is associated with a high rate of morbidity and mortality. Presently, there is neither an effective therapy to increase survival after intracerebral hemorrhage nor a treatment to improve the quality of life for survivors. ⋯ The "balloon" method has also been used to mimic ICH for study. In this summary, we intend to provide a comparative overview of the technical methods, aspects, and pathologic findings of these types of ICH models. We will also focus on the similarities and differences among these rodent models, achievements in technical aspects of the ICH model, and discuss important aspects in selecting relevant models for study.
-
Acta Neurochir. Suppl. · Jan 2011
Review Historical ArticleA clinical review of cerebral vasospasm and delayed ischaemia following aneurysm rupture.
The continuation of a review of delayed vasospasm after aneurysmal subarachnoid haemorrhage, originally published in 1994 and partially updated at the ninth vasospasm conference in Turkey, is presented. Further online and physical searches have been made of the relevant literature. The incidence of delayed ischaemic deficit (DID) or symptomatic vasospasm reported in 1994 was 32.5% in over 30,000 reported cases. ⋯ It thus appears likely that delayed vasospasm is still common but less so, and that the overall outcome has improved. This may be due to the more widespread use of calcium antagonists and more effective fluid management. A number of other mechanical and drug treatments are also mentioned.
-
Chronic subdural hematoma (CSDH) is a common neurosurgical condition that has a high incidence in the increasing elderly population of many countries. Pathologically, it is defined as a persistent liquefied hematoma in the subdural space more than 3 weeks old that is generally encased by a membraneous capsule. CSDHs likely originate after minor head trauma, with a key factor in its development being the potential for a subdural cavity to permit its expansion within, which is usually due to craniocerebral disproportion. ⋯ Current belief is that CSDH arises from recurrent bleeding in the subdural space, caused by a cycle of local angiogenesis, inflammation, coagulation and ongoing fibrinolysis. However, because of a lack of detailed knowledge about the precise mechanisms, treatment is often limited to surgical interventions that are invasive and often prone to recurrence. Thus, it is possible that an easily reproducible and representative animal model of CSDH would facilitate research in the pathogenesis of CSDH and aid with development of treatment options.
-
Acta Neurochir. Suppl. · Jan 2011
Case ReportsInformation-guided surgical management of gliomas using low-field-strength intraoperative MRI.
Contemporary technological developments revolutionized management of brain tumors. The experience with information-guided surgery of gliomas, based on the integration of the various intraoperative anatomical, functional, and histological data, is reported. ⋯ Information-guided management of gliomas using low-field-strength ioMRI provides a good opportunity for maximal possible tumor resection, and may result in survival advantage, particularly in patients with WHO grade III neoplasms.