Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Oct 2011
Supraorbital keyhole approach to upper basilar artery aneurysms via the optico-carotid window: a cadaveric anatomic study and preliminary application.
No anatomic data are available addressing the surgical indication for upper BA aneurysms via the supraorbital keyhole approach (SOKA). ⋯ When the width and length of the OCW are > 5 mm and > 7 mm, respectively, the SOKA can meet the requirement of exposure and manipulation of the upper BA. The upper BA aneurysms located < 10 mm higher than the anterior fossa and not more than 5 mm lower than the PCP can be treated via the SOKA. Posterior clinoidectomy and orbitectomy can increase the proximal and the distal exposure of the BA, respectively.
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Minim Invasive Neurosurg · Oct 2011
Individualized pterional keyhole clipping surgery based on a preoperative three-dimensional virtual osteotomy technique for unruptured middle cerebral artery aneurysm.
Individualized surgical simulation using three-dimensional (3D) imaging to allow safe performance of clipping surgery for unruptured middle cerebral artery (MCA) aneurysm via pterional keyhole mini-craniotomy was performed in 100 consecutive patients. ⋯ Pterional keyhole clipping surgery based on careful surgical simulation with 3D images is a safe and less invasive means to treat relatively small unruptured MCA aneurysms.
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Minim Invasive Neurosurg · Oct 2011
Case ReportsStereotactic brainstem biopsy in a patient with coagulopathy of unclear etiology: case report.
Parenchymal hemorrhage is one of the most feared risks of stereotactic brain biopsies potentially resulting in neurological deficits or even a fatal outcome. Patients with disorders of the coagulation system are at particular risk, so identifying these is one of the main tasks prior to surgery. Some patients may have a bleeding tendency despite normal laboratory values of the hemostatic system. ⋯ A medication scheme with tranexamic acid and desmopressin effectively decreased the patient's bleeding time in vivo and the procedure was carried out without complications.