Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Aug 2011
Review Case ReportsNeuroendoscopic management of intraventricular germinoma at the foramen of Monro: case report and review of the literature.
Intraventricular tumors account for approximately 3% of adult brain tumors and 16% of childhood and adolescent brain tumors. Half of the intraventricular tumors in adults and one quarter of those in children are found in the lateral ventricles. Ependymoma, astrocytoma, oligodendroglioma, choroid plexus papilloma, meningioma and subependymal giant cell astrocytoma are the common tumors encountered at this particular site. A germinoma at this site is rare. Microsurgery of intraventricular tumors can be challenging and is performed with potential functional and cognitive complications. ⋯ This report suggests that in selected cases endoscopic resection of an intraventricular tumor under frameless neuronavigation guidance is feasible and safe. The target can be precisely located and procedure-related adverse events can be minimized.
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Minim Invasive Neurosurg · Aug 2011
Simple, effective, supine positioning for the retrosigmoid approach.
The retrosigmoid approach is often used for posterior fossa pathology. Many variations of positioning exist. Here, we report a simple, safe, and quick positioning technique which maximizes patient safety, surgeon comfort, and intraoperative view. ⋯ Supine positioning for the retrosigmoid approach is an excellent and safe positioning alternative.
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Minim Invasive Neurosurg · Aug 2011
Minimally invasive retropleural approach for central thoracic disc herniation.
The management of symptomatic thoracic disc herniation (TDH) has evolved tremendously ever since the first laminectomy was performed. The last decade has witnessed the evolution of minimally invasive approaches for TDH most of which have been posterior/posterolateral. Traditional anterior approaches involve a thoracotomy or more recently, thoracoscopic techniques. The authors describe a less invasive anterior retropleural surgical approach to address central thoracic disk herniations which is less extensive than a thoracotomy and allows better anterior access than posterior or posterolateral approaches. The retropleural approach allows the use of the operative microscope with a tubular retractor in the anterior thoracic spine. ⋯ A minimally invasive retropleural approach using tubular retractor system for central thoracic disc herniation is feasible and may be a less invasive anterior alternative to a thoracotomy.
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Minim Invasive Neurosurg · Jun 2011
Frameless image-guided neuroendoscopy training in real simulators.
Over the last decade, neuroendoscopy has re-emerged as an interesting option in the management of intraventricular lesions in both children and adults. Nonetheless, as it has become more difficult to use cadaveric specimens in training, the development of alternative methods was vital. The aim of this study was to analyze the performance of a real simulator, in association with image-guided navigation, as a teaching tool for the training of intraventricular endoscopic procedures. ⋯ The use of real simulators in association with image-guided navigation proved to be an effective tool in training for neuroendoscopy.
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Minim Invasive Neurosurg · Jun 2011
Case ReportsSpontaneous debulking of middle fossa chordoma extension after transnasal petroclival biopsy--report of a case.
Clival chordomas are difficult tumors to treat, particularly when they have already grown beyond the confines of the clivus. ⋯ It is intriguing to think that leaving a path for easy egress for a chordoma from the clivus may prevent it from building up in the bone and spreading.