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Minimally Invasive Neurosurgery: MIN

J Y Cho, S-H Lee, H-Y Lee
BACKGROUND: 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...
October 2011: Minimally Invasive Neurosurgery: MIN
A E P Cameron, C Connery, J R M De Campos, M Hashmonai, P B Licht, C H Schick, G Bischof
No abstract text is available yet for this article.
October 2011: Minimally Invasive Neurosurgery: MIN
M Hayashi, M Chernov, N Tamura, M Tamura, M Izawa, Y Muragaki, H Iseki, Y Okada
BACKGROUND: Radiosurgical management of large cystic metastatic brain tumors represents a significant challenge. Nevertheless, modified dose planning has shown beneficial results in such cases. METHOD AND RESULTS: "Donut's shape" radiosurgical treatment planning is based on the chain-like application of multiple, small-sized isocenters for selective coverage of the contrast-enhancing tumor capsule and minimal irradiation of the central cystic area. Such an approach was used for the management of large cystic intracranial metastases, which were not accompanied by a significant mass effect and did not require immediate volume reduction...
October 2011: Minimally Invasive Neurosurgery: MIN
S Chibbaro, O Makiese, D Bresson, S Hamdi, J F Cornelius, J P Guichard, A Reiss, S Bouazza, E Vicaut, A Ricci, R Galzio, P Poczos, B George, M Marsella, P Di Emidio
BACKGROUND: After completing a craniotomy, it is important to replace the removed bone flap in its natural position in order to guarantee brain protection as well as improve cosmesis. A skull defect can expose the brain to accidental damage, and in cases of larger defects it may also cause the patients psychosocial problems. The ideal fixation device should provide reliable attachment of the flap to the skull and promote fast bony healing to avoid possible pseudo-arthrosis and/or osteolytic changes...
October 2011: Minimally Invasive Neurosurgery: MIN
V Waran, K Sek, N F Bahuri, P Narayanan, H Chandran
In endoscopic neurosurgery problems with haemostasis due to poor access exist. We have developed a system which allows the delivery of a variety of haemostatic agents in a more efficacious manner. The system has been used successfully in endoscopic skull base surgery and endoscopic surgery within the parenchyma of the brain using tube systems.
October 2011: Minimally Invasive Neurosurgery: MIN
R Koppula, A Singh, F Roberti
We present a short anatomic report on the feasibility of an endoscopic resection of an Os odontoideum, with preservation of the anterior arch of the atlas.
October 2011: Minimally Invasive Neurosurgery: MIN
T Menovsky, D De Ridder
Microsuturing in a narrow and/or a deep operating space is technically challenging and classical microinstruments such as a bayonet microneedle-holder have their limitation, mainly related to their in-built rigidity. In this technical note, a new flexible and 360° rotating shaft microneedle-holder made from nitinol is presented.
October 2011: Minimally Invasive Neurosurgery: MIN
K Ikuta, K Tarukado, H Senba, T Kitamura, N Komiya, Y Fukutoku, S Shidahara
BACKGROUND: Microendoscopic discectomy (MED) is one of the minimally invasive endoscopic procedures for treating lumbar disc herniation. The aim of this case report is to describe a patient with thoracic ossification of the ligamentum flavum (OLF) that was completely removed using the microendoscopic technique. CASE REPORT: We report on a 62-year-old male patient who presented with thoracic myelopathy caused by OLF at the Th11-12. A posterior decompression via spinous process splitting approach using the microendoscopic technique at the Th11-12 was performed...
October 2011: Minimally Invasive Neurosurgery: MIN
C Beynon, T Hoffmann, W Wick, A W Unterberg, K L Kiening
BACKGROUND: 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. CASE REPORT: We report the case of a patient with coagulopathy of unclear etiology undergoing a stereotactic brainstem biopsy...
October 2011: Minimally Invasive Neurosurgery: MIN
D Reddy, T Gunnarsson, K Scheinemann, J P Provias, S K Singh
BACKGROUND: Choroid plexus papillomas of the third ventricle in newborn infants are quite rare and present a significant surgical challenge. This case report illustrates the utility of endoscopy in facilitating tumor resection. PATIENT: A 6-week-old boy, born prematurely at a gestational age of 35 weeks, presented with hydrocephalus secondary to a choroid plexus papilloma in the third ventricle, extending to the aqueduct of Sylvius and into the fourth ventricle...
October 2011: Minimally Invasive Neurosurgery: MIN
A Sieskiewicz, T Lyson, M Rogowski, R Rutkowski, Z Mariak
BACKGROUND: Bony defects extending laterally or superiorly within the posterior wall of the frontal sinus are generally deemed too difficult for endoscopic repair in spite of significant progress in surgical endoscopic techniques. PATIENTS AND METHODS: We describe a technique of endoscopic repair of posttraumatic cerebrospinal fluid (CSF) leak from the postero-superior aspect of the frontal sinus in a 40- and a 29-year-old male. In both cases after careful assessment of the surgical anatomy the sinus was widely opened transnasally (Draf IIB and Draf III approach, respectively)...
October 2011: Minimally Invasive Neurosurgery: MIN
T Menovsky, M Plazier, R Rasschaert, A I R Maas, P M Parizel, S Verbeke
BACKGROUND: Oxidized regenerated cellulose is commonly used in many surgical fields as a hemostatic agent. Complications related to swelling or compression after application of small portions of Surgicel® Fibrillar™ have not yet been described. PATIENTS: We report on a 65-year-old woman who was operated for a high-grade spinal stenosis at the L2-L3 level. Small portions of Surgicel® Fibrillar™ were used to control bleeding from the epidural venous plexus. The immediate postoperative course was uneventful...
October 2011: Minimally Invasive Neurosurgery: MIN
M Lefranc, J Peltier, A Fichten, P Toussaint, D Le Gars
BACKGROUND: We report on a dual percutaneous fixation in 2 patients with a double thoracic spine fracture. The advantages and limitations of this new approach for treating traumatic spinal fractures are reviewed. CLINICAL PRESENTATION: A 67-year-old male was admitted following a fall from a height of 3 m. A neurological examination revealed sub-T11 motor and sensory paraparesis. There were a T6 vertical body and bi-articular fracture and a T11 vertebral burst fracture with > 75% posterior wall damage...
October 2011: Minimally Invasive Neurosurgery: MIN
N McLaughlin, D Bresson, L F S Ditzel Filho, R L Carrau, D F Kelly, D M Prevedello, A B Kassam
BACKGROUND: Lesions originating in the vidian canal are extremely rare. Most frequently, they are extensions from contiguous carcinomas. We present a rare case of a vidian nerve neurofibroma and discuss its surgical management. CASE REPORT: A 62-year-old woman with a history of a basal cell skin cancer was evaluated for bilateral tinnitus. Imaging revealed a left-sided lesion at the medial aspect of the pterygoid process base, over the vidian canal. Under image-guidance, an endonasal endoscopic transpterygoid approach was performed...
October 2011: Minimally Invasive Neurosurgery: MIN
G B de Aguiar, M L M Conti, J C E Veiga, M Jory
INTRODUCTION: Arteriovenous fistulas (AVF) are rare vascular lesions of the brain that differ from arteriovenous malformations as they present a direct connection between artery and vein, without interposition of the nidus. They are fed by one or more arterial branches, with a single draining vein. Clinically they can be revealed through cerebral hemorrhage, convulsive crisis, neurological deficit, heart failure in neonates and infants, headache, bruit, or intracranial hypertension symptoms...
October 2011: Minimally Invasive Neurosurgery: MIN
D A Chesler, C Pendleton, G I Jallo, A Quiñones-Hinojosa
BACKGROUND: In 1908, Anton and von Bramann proposed the Balkenstich method, a corpus callosum puncture which created a communication between the ventricle and subarachnoid space. This method offered the benefit of providing continuous CSF diversion without the implantation of cannula or other shunting devices, yet it received only slight reference in the literature of the time. It remained a novel and perhaps underutilized approach at the time Cushing began expanding his neurosurgical practice at the Johns Hopkins Hospital...
October 2011: Minimally Invasive Neurosurgery: MIN
V Krishna, B Blaker, L Kosnik, S Patel, W Vandergrift
BACKGROUND: The trans-lamina terminalis approach has been described to remove third ventricular tumors. Various surgical corridors for this approach include anterior (via bifrontal craniotomy), anterolateral (via supra-orbital craniotomy), lateral (via pterional craniotomy) and trans-sphenoidal corridors. Supra-orbital craniotomy offers a minimally invasive access for resection of third ventricular tumors. MATERIAL AND METHODS: The trans-lamina terminalis technique through a supra-orbital craniotomy is described...
October 2011: Minimally Invasive Neurosurgery: MIN
Y Ma, Q Lan
BACKGROUND: No anatomic data are available addressing the surgical indication for upper BA aneurysms via the supraorbital keyhole approach (SOKA). OBJECTIVE: An anatomic study of the SOKA to the upper BA via the optico-carotid window (OCW) was designed. Our clinical experience is reported. METHODS: After completing the SOKA craniotomy on 8 cadaveric heads, the width and length of OCW and the length of the supraclinoid internal carotid artery (SCICA) were measured...
October 2011: Minimally Invasive Neurosurgery: MIN
F Komatsu, M Komatsu, A Di Ieva, M Tschabitscher
BACKGROUND: Persistent trigeminal artery (PTA) is one of the carotid-basilar anastomoses and occasionally complicates vascular or neoplastic pathology. The aim of this study was to become more familiar with the anatomy associated with PTA using an endoscopic view. MATERIAL AND METHODS: PTA was incidentally encountered in a fresh cadaver. Purely endoscopic approaches via supraorbital (extradural and intradural routes), endonasal, and retrosigmoid routes were performed with 4-mm, 0- and 30-degree rigid endoscopes...
October 2011: Minimally Invasive Neurosurgery: MIN
D Logé, O De Coster, W Pollet, T Vancamp
BACKGROUND: In spinal cord stimulation (SCS) mainly 2 distinctive implantation techniques can be recognized: the percutaneous and surgical technique. MATERIAL AND METHODS: A puncture is made with a blunt 14 gauge Tuohy needle. Once inside the epidural space the guide wire needs to be advanced in the epidural space, then the Tuohy needle is removed. The Epiducer is advanced under the guidance of lateral fluoroscopy, to confirm epidural entry. The S-series electrode is introduced through the sheet in the epidural space...
October 2011: Minimally Invasive Neurosurgery: MIN
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