Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Oct 2011
Prevention of development of postoperative dysesthesia in transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation: floating retraction technique.
Transforaminal percutaneous endoscopic lumbar discectomy (PELD) has become a routine surgical procedure because it is minimally invasive. Perioperative complications such as dural injury, infection, nerve root irritation and recurrence can occur not only with PELD, but also with conventional open microsurgery. In contrast, post-operative dysesthesia (POD) due to existing dorsal root ganglion (DRG) injury is a unique complication of PELD. When POD occurs, even if the traversing root has been successfully decompressed, it hinders swift recovery and delays the return to daily routines. Thus, prevention of POD is the key to successful and widespread use of PELD. ⋯ Transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation is a safe and effective procedure. The floating retraction technique is recommended to avoid development of POD.
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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.
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Minim Invasive Neurosurg · Aug 2011
The supraorbital approach for recurrent or residual suprasellar tumors.
Suprasellar tumors can be removed through a variety of approaches including conventional frontotemporal craniotomies, the transsphenoidal route, or the supraorbital (SO) eyebrow craniotomy. Herein we assess the utility of the SO route for recurrent or residual suprasellar tumors previously treated by an alternative route. ⋯ The SO approach should be considered as a safe and effective alternative route for recurrent or residual suprasellar tumors previously treated by conventional craniotomy or TS surgery. It typically offers a simplified trajectory that minimizes scar tissue from prior approaches and provides excellent access for optic apparatus decompression. Endoscopy is helpful to visualize hidden tumor remnants and maximize safe tumor removal.
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Minim Invasive Neurosurg · Aug 2011
Purely endoscopic removal of intraventricular brain tumors: a consensus opinion and update.
The main purpose of this project is to define the major indications, preferences, techniques, limitations, and complications associated with intraventricular tumor removal using purely endoscopic techniques. ⋯ Endoscopic intraventricular surgery is a feasible minimally invasive alternative to open transcranial surgery for specific ventricular tumors. With the currently available instrumentation, the technique can be applied to small avascular solid intraventriclular tumors and colloid cysts of the third ventricle. The majority of the complications are based on hemostasis potential. The development of compatible instrumentation with an enhanced ability for solid tumor removal and more adequate hemostasis appear to be the principle limitations in furthering the technique of endoscopic removal of intraventricular brain tumors.