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Neurosurgery technique

Serrano-Rubio Alejandro, Ruiz-Treviño Armando S, Orenday-Barraza Jose M, Vázquez-Gregorio Rafael, Lee Angel, Nathal Edgar
OBJECT: The use of intraoperative fluorescence has proven to be a useful tool in multiple neurosurgical procedures with a potential utility in treating arteriovenous malformations (AVMs). The aim of this study was to characterize dynamic changes of an AVM using a microscope-integrated technique at the moment of performing an intraoperative Sodium fluorescein videoangiography (FL-VAG) at each of the resection phases. METHODS: Our study at the National Institute of Neurology and Neurosurgery-Mexico City, prospectively recruited twelve patients harboring an AVM, using FL-VAG as an ancillary technique for the resection of the lesion...
June 12, 2018: World Neurosurgery
Anne-Hélène Clair, William Haynes, Luc Mallet
Deep brain stimulation (DBS) has been offered to patients suffering of severe and resistant neuropsychiatric disorders like Obsessive Compulsive Disorder (OCD), Gilles de la Tourette Syndrome (TS) and Major Depression (MDD). Modulation of several targets within the cortico-striato-thalamo-cortical circuits can lead to a decrease of symptom severity in those patients. This review focuses on the recent clinical outcomes in DBS in psychiatric disorders. Studies on OCD and TS are now focusing on the long-term effects of DBS, with encouraging results regarding not only the decrease of symptoms, but also quality of life...
2018: F1000Research
Devi Prasad Patra, Amey Rajan Savardekar, Rimal Hanif Dossani, Vinayak Narayan, Nasser Mohammed, Anil Nanda
The history of neurosurgery is ever fascinating. The journey has been tedious, nevertheless, in the landscape of success and failures we have become more efficient and polished. Skills were learned, innovations were made, and in the process we evolved. The immense contribution of meninigioma surgery in this maturation process is attested by history itself. Countless stories exist in the literature that would testify the momentous role of meningioma in the process of evolution and reformation of neurosurgical techniques...
June 11, 2018: World Neurosurgery
Ruichong Ma, Cheryl A Coulter, Laurent J Livermore, Natalie L Voets, Omar Al Awar, Puneet Plaha
BACKGROUND: Surgical access to the temporal lobe is complex with many eloquent white fiber tracts, requiring careful pre-operative surgical planning. Many microsurgical approaches to the temporal lobes are described, each with their own disadvantages. The adoption of the endoscope in neurosurgery has increased the options available when treating these difficult access tumors. OBJECTIVES: We present our experience of a novel, minimally-invasive, endoscopic approach to resect temporal lobe tumors...
June 11, 2018: World Neurosurgery
Marie T Krüger, Volker A Coenen, Karl Egger, Mukesch Shah, Peter C Reinacher
BACKGROUND: In recent years, simulations based on phantom models have become increasingly popular in the medical field. In the field of functional and stereotactic neurosurgery, a cranial phantom would be useful to train operative techniques, such as stereo-electroencephalography (SEEG), to establish new methods as well as to develop and modify radiological techniques. In this study, we describe the construction of a cranial phantom and show examples for it in stereotactic and functional neurosurgery and its applicability with different radiological modalities...
June 13, 2018: Stereotactic and Functional Neurosurgery
P Qi, J J Wang, L J Wang, J Lu, S Hu, X M Yang, K P Chen, H F Wang, D M Wang
Objective: To explore the safety and short-term efficacy of sole angioplasty with tiny balloon for symptomatic intracranial atherosclerotic stenosis (ICAS) patients with complex lesions refractory. Methods: Consecutive 11 patients with complex ICAS lesions treated by sole angioplasty with tiny balloon (diameter≤2 mm) from September 2016 to November 2017 at Department of Neurosurgery, Beijing Hospital were retrospectively reviewed. Patients' demographics, lesions characteristics, procedures, complications, and clinical and imaging follow-up data were collected...
June 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Derek Yecies, Nathaniel Fogel, Michael Edwards, Gerald Grant, Kristen W Yeom, Samuel Cheshier
OBJECT: The need for neurosurgical supervision as well as the general safety and utility of dynamic MRI of the cervical spine in children remains controversial. We present the largest descriptive cohort study of cervical flexion-extension MRIs in a pediatric population to help elucidate the safety and utility of this technique. METHODS: All cervical spine MRIs performed at Lucile Packard Children's Hospital at Stanford from 2009-2015 were retrospectively reviewed...
June 5, 2018: World Neurosurgery
Juan C Fernandez-Miranda
The medial temporal lobe can be divided in anterior, middle, and posterior segments. The anterior segment is formed by the uncus and hippocampal head, and it has extra and intraventricular structures. There are 2 main approaches to the uncohippocampal region, the anteromedial temporal lobectomy (Spencer's technique) and the transsylvian selective amygdalohippocampectomy (Yasargil's technique).In this video, we present the case of a 29-yr-old man with new onset of generalized seizures and a contrast-enhancing lesion in the left anterior segment of the medial temporal lobe compatible with high-grade glioma...
June 7, 2018: Operative Neurosurgery (Hagerstown, Md.)
Gabriella Panuccio, Ilaria Colombi, Michela Chiappalone
Temporal lobe epilepsy (TLE) is the most common partial complex epileptic syndrome and the least responsive to medications. Deep brain stimulation (DBS) is a promising approach when pharmacological treatment fails or neurosurgery is not recommended. Acute brain slices coupled to microelectrode arrays (MEAs) represent a valuable tool to study neuronal network interactions and their modulation by electrical stimulation. As compared to conventional extracellular recording techniques, they provide the added advantages of a greater number of observation points and a known inter-electrode distance, which allow studying the propagation path and speed of electrophysiological signals...
May 15, 2018: Journal of Visualized Experiments: JoVE
Jose Armando Gonzales Zamora, Zachary Henry, Sakir Humayun Gultekin
Post-surgical aspergillosis is an uncommon complication that carries a high mortality rate in affected patients. The diagnosis is challenging given the lack of highly sensitive methods to isolate Aspergillus from surgical sites. Here, we present a case of post-surgical aspergillosis that occurred after the resection of acoustic neuroma in an immunocompetent patient. Imaging revealed leptomeningeal enhancement and a cerebellar extra-axial fluid collection adjacent to the right retrosigmoid craniotomy. The patient was taken to the operating room for debridement, where purulent fluid was obtained from subdural space...
May 31, 2018: Diseases (Basel)
Max Wintermark, Rivka Colen, Christopher T Whitlow, Gregory Zaharchuk
Significant advances in anatomical and functional neuroimaging techniques have allowed researchers and clinicians to visualize the brain in action. The field of neuroimaging currently includes newer and faster scanners, improved image quality, higher spatial and temporal resolution, and diverse methods of acquisition and analysis. Beyond simply imaging brain structures, these developments enable quantitative assessment of the microstructural and functional architecture, perfusion, and metabolism of the brain...
May 31, 2018: British Journal of Radiology
Pervinder Bhogal, Jorge Chudyk, Carlos Bleise, Ivan Lylyk, Hans Henkes, Pedro Lylyk
Objective The objective of this study was to report our experience on the use of flow diverting stents placed within the posterior inferior cerebellar artery (PICA) as a treatment option for aneurysms of the PICA. Methods Three patients with aneurysms of the PICA, both ruptured and unruptured, underwent treatment of their aneurysms with placement of a single flow diverter in the PICA across the neck of the aneurysm. Adjunctive techniques such as coiling were not used. We present the angiographic and clinical follow-up data...
January 1, 2018: Interventional Neuroradiology
Marc N Gallay, David Moser, Daniel Jeanmonod
OBJECTIVE Since the first clinical application of the incisionless magnetic resonance-guided focused ultrasound (MRgFUS) technology only small series of patients have been reported, and thus only extrapolations of the procedure-related risks could be offered. In this study, the authors analyze side-effects and targeting accuracy in 180 consecutive treatments with MRgFUS for chronic therapy-resistant idiopathic Parkinson's disease (PD), essential tremor (ET), cerebellar tremor (CT), and neuropathic pain (NP), all performed in their dedicated center...
May 25, 2018: Journal of Neurosurgery
Vadim A Byvaltsev, Serik K Akshulakov, Roman A Polkin, Sergey V Ochkal, Ivan A Stepanov, Yerbol T Makhambetov, Talgat T Kerimbayev, Michael Staren, Evgenii Belykh, Mark C Preul
Cerebrovascular diseases are among the most widespread diseases in the world, which largely determine the structure of morbidity and mortality rates. Microvascular anastomosis techniques are important for revascularization surgeries on brachiocephalic and carotid arteries and complex cerebral aneurysms and even during resection of brain tumors that obstruct major cerebral arteries. Training in microvascular surgery became even more difficult with less case exposure and growth of the use of endovascular techniques...
2018: Minimally Invasive Surgery
R S Dzhindzhikhadze, O N Dreval', V A Lazarev, A V Polyakov, R L Kambiev
The concept of minimally invasive neurosurgery has significantly evolved in recent years, which is associated with improvements in diagnostics, microneurosurgical techniques, anesthesiology, and intraoperative imaging. MATERIAL AND METHODS: We present the preliminary results of using transpalpebral craniotomy in surgery of supratentorial aneurysms and anterior cranial fossa tumors. In the period between 2015 and 2107, we used this approach in surgical treatment of 30 aneurysms (10 aneurysms in the 'cold' period of hemorrhage and 20 unruptured aneurysms) and 10 anterior cranial fossa base tumors...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Claudio Cavallo, Camilla De Laurentis, Ignazio G Vetrano, Jacopo Falco, Morgan Broggi, Marco Schiariti, Paolo Ferroli, Francesco Acerbi
INTRODUCTION: Sodium Fluorescein (SF) is a green, water-soluble dye with the capacity to accumulate in cerebral areas as a result of damaged blood-brain barrier (BBB); this property allows SF to concentrate specifically at the tumor site of various types of brain neoplasms, making the tumor tissue more clearly visible. EVIDENCE ACQUISITION: A literature search (1947-2018) was conducted with the keywords "fluorescein neurosurgery", "YELLOW neurosurgery", "fluorescein brain tumor", "YELLOW brain tumor"...
May 22, 2018: Journal of Neurosurgical Sciences
Mohammed Aref, A Samy Youssef
The tremendous advances in endoscopic skull base surgery added new a set of intricate less invasive approaches to the neurosurgical armamentarium. The new generations of neurosurgeons face the challenge of adopting the ever-changing technology and quickly learning modern surgical techniques beyond the traditional neurosurgery comfort zone. The future skull base surgeon must be well trained and knowledgeable in all surgical portals to the skull base in order to select the safest least invasive, most direct approach that offers the optimum exposure to handle a complex skull base pathology...
May 22, 2018: Journal of Neurosurgical Sciences
Shizuya Yamashita, Daisaku Masuda, Hidenori Arai, Yuji Matsuzawa
AIMS: To gain a more accurate understanding of the current real-world management of dyslipidemia in Japan, an online survey was conducted in a variety of physicians from five medical fields. METHODS: A web-based survey with online questionnaire was designed, and members of an on-line information service for physicians were invited to participate. The survey enrolled 500 physicians, 100 in each of five categories: cardiology; diabetes, metabolism and endocrinology; neurology/neurosurgery/stroke medicine; general internal medicine (hospitals ≥20 beds), and general internal medicine (self-employed practitioners at clinics or small hospitals ≤19 beds)...
May 18, 2018: Journal of Atherosclerosis and Thrombosis
Martin Hampl, David Kachlik, Katerina Kikalova, Roxane Riemer, Matej Halaj, Vlastimil Novak, Premysl Stejskal, Miroslav Vaverka, Lumir Hrabalek, David Krahulik, Ondrej Nanka
BACKGROUND: Mastoid emissary vein is especially important from the neurosurgical point of view, because it is located in variable number in the area of the occipitomastoid suture and it can become a source of significant bleeding in surgical approaches through the mastoid process, especially in retrosigmoid craniotomy, which is used for approaches to pathologies localized in the cerebellopontine angle. Ideal imaging method for diagnosis of these neglected structures when planning a surgical approach is high-resolution computed tomography...
May 20, 2018: Acta Neurochirurgica
Hua Gao, Chunhui Liu, Yazhuo Zhang
The endoscope has traditionally been used in neurosurgery to access a lesion within a natural body cavity. The challenge has been to access and resect deep-seated intraparenchymal lesions using a minimally invasive endoscopic technique. Endoscopic endonasal trans-sphenoidal surgery has gained increasing acceptance by otolaryngologists and neurosurgeons. Surgical procedures of the skull base include exposure, resection, and base reconstruction. These approaches start at the sphenoid sinus, which provides a reference point to important vascular and neural structures...
May 14, 2018: Clinical Neurology and Neurosurgery
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