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Acta Neurochirurgica

Lukas Grassner, Franz Marhold, Yousif Miron, Andreas Grillhösl, Karl Ungersboeck, Joachim Schulz, Martin Strowitzki
BACKGROUND: Decompressive craniectomy is a commonly performed procedure. It reduces intracranial pressure, improves survival, and thus might have a positive impact on several neurosurgical diseases and emergencies. Sometimes primary skin closure is not possible due to cerebral herniation or extensive skin defects. In order to prevent further restriction of the underlying tissue, a temporary skin expansion might be necessary. METHODS AND MATERIAL: We retrospectively reviewed patients in need for a temporary skin substitute because skin closure was not possible after craniectomy without violating brain tissue underneath in a time period of 6 years (2011-2016)...
December 4, 2018: Acta Neurochirurgica
Shintaro Arai, Tohru Mizutani, Tatsuya Sugiyama, Kenji Sumi, Takato Nakajo, Masaki Matsumoto, Katsutoshi Shimizu
BACKGROUND: There have been no long-term follow-up reports pertaining to chronological size changes in large or giant unruptured intracranial aneurysms treated with surgical parent artery occlusion (PAO). The object of this study is to investigate the utility and safety of surgical PAO by conducting a long-term follow-up of chronological aneurysm size changes and outcomes. METHODS: A retrospective study of 21 unruptured intracranial aneurysms measuring over 10 mm (20 patients) treated with surgical PAO in the period 2012-2017 was conducted...
December 4, 2018: Acta Neurochirurgica
Masaki Mino, Miki Fujimura, Masahiro Yoshida, Shinya Sonobe, Teiji Tominaga
BACKGROUND: The optimal management strategy for cerebral contusion remains controversial, especially when standard craniotomy could not be used. We performed neuro-endoscopic target lesionectomy for the delayed progression of cerebral contusion in order to aspirate the necrotic core, which is the primal source of contusional edema. METHODS: The present study included 10 consecutive patients (2 women and 8 men, with a mean age of 67 years old) with traumatic brain injury presenting with delayed deterioration of cerebral contusion where standard craniotomy could not be used...
December 4, 2018: Acta Neurochirurgica
Jang Hun Kim, Soon-Young Hwang, Taek-Hyun Kwon, Kyuha Chong, Won-Ki Yoon, Jong Hyun Kim
BACKGROUND: Although cranioplasty (CP) is a frequently performed and simple procedure, complications are common, particularly bone flap resorption and infection. The timing of surgery is as an important contributory factor, but the optimal timing has not been clearly determined. OBJECTIVE: We retrospectively investigated bone flap resorption and surgical site infection after CP to determine the optimal timing of surgery for reduction of complications. METHODS: The study enrolled 126 patients who underwent decompressive craniectomy (DC) and subsequent CP...
December 4, 2018: Acta Neurochirurgica
Tao Huang, Nan-Xiang Xiong, Peng Fu, Ahmed Abdelmaksoud, Lei Wang, Hong-Yang Zhao
Bilateral hemifacial spasm (biHFS) is an infrequent cranial nerve disorder that causes patients to suffer from severe psychological stress, and there are no reported cases of synchronous biHFS. In this study, a 46-year-old right-handed woman was diagnosed with a synchronous biHFS. After one unilateral microvascular decompression (MVD) surgery, the left facial twitching movements relieved immediately, and the right side twitching movements self-relieved the next day. Although there was a delayed hemorrhage, the patient achieved a satisfactory outcome defined as cessation of the twitching movements without recurrence...
December 4, 2018: Acta Neurochirurgica
André Grotenhuis
No abstract text is available yet for this article.
December 3, 2018: Acta Neurochirurgica
Ali Akhaddar, Mehmet Turgut
No abstract text is available yet for this article.
November 30, 2018: Acta Neurochirurgica
Shadi Al-Afif, Joachim K Krauss
No abstract text is available yet for this article.
November 29, 2018: Acta Neurochirurgica
Luciano Mastronardi, Ettore Di Scipio, Guglielmo Cacciotti, Raffaelino Roperto, Carlo Giacobbo Scavo
BACKGROUND AND OBJECTIVE: Goals of small vestibular schwannoma (VS) microneurosurgery are as follows: radical resection, facial nerve (FN) preservation, and hearing preservation (HP). Microsurgical advances make HP possible in many patients with preoperative socially useful hearing (SUH). We evaluated postoperative HP in VS with maximum diameter < 2 cm monitored with two different auditory brainstem response (ABR) techniques. MATERIALS AND METHODS: Twenty-eight consecutive non-randomized patients with SUH suffering from small VS underwent keyhole microneurosurgery by retrosigmoid (RS) approach...
November 27, 2018: Acta Neurochirurgica
Depeng Meng, Huihao Chen, Yaofa Lin, Haodong Lin, Chunlin Hou
BACKGROUND: Sciatic nerve injuries cause significant disability. We propose here a novel reconstructive procedure of transferring the motor branches of the femoral nerve as donor nerves to reconstruct both the peroneal and tibial nerve function as a novel approach to treat high sciatic nerve injury. METHODS: The autopsies of donor nerves (vastus lateralis nerve branch (VLN), vastus medialis nerve branch (VMN), saphenous nerve (SAN)) and respective recipient nerves (deep peroneal nerve branch (DPN), medial gastrocnemius nerve branch (MGN), sural nerve (SN)) were conducted in six fresh-frozen lower limbs...
November 27, 2018: Acta Neurochirurgica
Ali Alomari, Christian Jaspers, Wolf-Dieter Reinbold, Joachim Feldkamp, Ulrich J Knappe
BACKGROUND: Perisellar infiltration may be responsible for incomplete removal of pituitary tumors. Since intraoperative visualization of parasellar structures is difficult during transsphenoidal surgery, we are describing the use of intraoperative direct contact ultrasound (IOUS). METHODS: Within 5 years, in 113 transsphenoidal operations (58 male, 55 female, age 14-81 years, 110 pituitary adenomas (mean diameter 26.6 mm, 69 non-secreting adenomas, 41 secreting adenomas), and 1 of each Rathke's cleft cyst, craniopharyngioma, and xanthogranuloma), IOUS was applied...
November 27, 2018: Acta Neurochirurgica
Martin N Stienen, Nathalie Moser, Philipp Krauss, Luca Regli, Johannes Sarnthein
BACKGROUND: Today, there are only few reports on the incidence of surgical site infections (SSIs) in neurosurgery. The objective of this work was to determine the rate of SSI at a tertiary neurosurgical department for benchmarking purpose. METHODS: Data of consecutive patients undergoing neurosurgical treatment between January 2013 and December 2016 were prospectively entered into a registry. SSIs were diagnosed according to the 2017 Centers for Disease Control and Prevention criteria, with severity graded according to the Clavien-Dindo grade (CDG)...
November 27, 2018: Acta Neurochirurgica
Carlo Serra, Martina Sebök, Lukas Widmer, Marian Christoph Neidert, Luca Regli
The concomitant presence of an aneurysm in contact with a sellar lesion usually contraindicates a transsphenoidal approach (TSS). Clipping of an intracranial aneurysm is however possible in highly selected cases also through an endoscopic TSS approach, as long as the basic principles of cerebrovascular surgery are respected. We report thus on a case of a patient harboring a Rathke cleft cyst (RCC) and an aneurysm of the carotid artery (ICA) in close contact with the RCC. The anatomical characteristics of both lesions warranted an endoscopic TSS for removal of the RCC and clipping of the aneurysm during the same approach...
November 26, 2018: Acta Neurochirurgica
Eno Lavrysen, Tomas Menovsky
BACKGROUND: Burr hole surgery for moyamoya disease and moyamoya syndrome is known to be an effective, versatile, and relatively simple revascularization technique. We will focus on the technical operative aspects of multiple burr hole surgery as we perform it in our center. METHODS: Periosteal flaps are prepared and placed in a burr hole with beveled edge, after opening the dura and arachnoid membrane, in order to facilitate neovascularization into the ischemic cortex...
November 24, 2018: Acta Neurochirurgica
Hussam Abou-Al-Shaar, Abdullah M Abunimer, Timothy G White, Amir R Dehdashti
No abstract text is available yet for this article.
November 23, 2018: Acta Neurochirurgica
Sofia Kamakh Asaad, Carsten Reidies Bjarkam
BACKGROUND: Acutely increased intracranial pressure (ICP) is frequently managed by external ventricular drainage (EVD). This procedure is life-saving but marred by a high incidence of complications. It has recently been indicated that bolt-connected external ventricular drainage (BC-EVD) compared to the standard technique of tunnelled EVD (T-EVD) may result in less complications. AIM: To prospectively sample and compare two cohorts by consecutive allocation to either BC-EVD or T-EVD from the introduction of the BC-EVD technique in our department and 12 months onward...
November 23, 2018: Acta Neurochirurgica
Morten Lund-Johansen
No abstract text is available yet for this article.
November 22, 2018: Acta Neurochirurgica
S Saini, J Kanwar, S Gupta, S Behari, E Bhatia, Subhash Yadav
BACKGROUND: The results of trans-sphenoidal surgery (TSS) in Cushing's disease (CD) vary widely depending upon patient characteristics as well as surgical experience. Patients in India are often referred late to referral centers. We studied the rates of remission and endocrine deficiencies after TSS in patients with CD presenting to a referral hospital in India. METHODS: Sixty consecutive patients (45 females, median age 24.5 years) who underwent TSS between 2000 and 2015 were studied...
November 21, 2018: Acta Neurochirurgica
Jasper Kees Wim Gerritsen, Lidia Arends, Markus Klimek, Clemens Maria Franciscus Dirven, Arnaud Jean-Pierre Edouard Vincent
BACKGROUND: Intraoperative stimulation mapping (ISM) using electrocortical mapping (awake craniotomy, AC) or evoked potentials has become a solid option for the resection of supratentorial low-grade gliomas in eloquent areas, but not as much for high-grade gliomas. This meta-analysis aims to determine whether the surgeon, when using ISM and AC, is able to achieve improved overall survival and decreased neurological morbidity in patients with high-grade glioma as compared to resection under general anesthesia (GA)...
November 21, 2018: Acta Neurochirurgica
Parmenion P Tsitsopoulos
No abstract text is available yet for this article.
November 21, 2018: Acta Neurochirurgica
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