Abstract:
BACKGROUND:Surgical treatment of petroclival meningiomas remains challenging. In order to refine indications for the use of stereotactic radiosurgery in the treatment of these tumours, we retrospectively evaluated our experience in this field. METHODS:Thirty-two patients harboring a petroclival meningioma were treated consecutively using a Gamma knife between December 92 and June 1998. Eight patients underwent radiosurgery after one or more attempted surgical removals and 24 had radiosurgery as the primary treatment. The main symptoms before radiosurgery were cranial nerve palsies, including a sixth nerve deficit in 10 patients and a trigeminal nerve disturbance in 9. All patients underwent a conformal multi-isocentric treatment (mean isocenter's number 8.8) and the dose delivered at the tumour margin ranged from 10 to 15 Gy (mean dose 13 Gy). FINDINGS:The duration of follow-up varied from 24 to 118 months (mean clinical follow-up 56 months, mean radiological follow-up 52.6 months). All 32 patients survived. The tumour volume remained unchanged in 28 patients and decreased slightly in 4. Neurological status worsened permanently in 2 patients with a delayed hemiparesis due to focal pontine infarction. These complications were associated with large meningiomas with vascular involvement and ventral brainstem compression, and occurred at the very early stage of our experience. At last follow-up, preoperative fifth or sixth cranial nerve deficits had improved or recovered in 13 out of 19 patients and any delayed worsening or new cranial nerve deficits were not observed after radiosurgery. CONCLUSIONS:Stereotactic radiosurgery with a Gamma knife provides effective management of small to middle sized petroclival meningiomas and is an alternative to microsurgery. Careful selection of patients and use of major technical refinements should improve the safety of this treatment.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Roche PH,Pellet W,Fuentes S,Thomassin JM,Régis Jdoi
10.1007/s00701-003-0123-1subject
Has Abstractpub_date
2003-10-01 00:00:00pages
883-8; discussion 888issue
10eissn
0001-6268issn
0942-0940journal_volume
145pub_type
杂志文章abstract:OBJECTIVE:To present a patient with a cervico-thoracic ventrally located epidural hematoma caused by dissection and subsequent bleeding of the cervical portion of the vertebral artery. SUMMARY AND BACKGROUND DATA:Non traumatic epidural hematoma is a rare entity. The etiology usually is not clarified: a venous origin i...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0223-7
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:To study an effective method for surgical management of vertebral and basilar artery aneurysms. METHODS:Forty-one patients with 43 aneurysms of the vertebral and basilar arteries were managed by microsurgical clipping. Cerebral angiography revealed basilar apex aneurysms in 17 patients, basilar trunk in six ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1656-6
更新日期:2013-06-01 00:00:00
abstract:INTRODUCTION:Advances in radiological imaging techniques have enabled volumetric measurements of meningiomas to be easily monitored using serial imaging scans. There is limited literature on the relationship between tumour growth rates and the WHO classification of meningiomas despite tumour growth being a major determ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3277-y
更新日期:2017-11-01 00:00:00
abstract::1. The use of rapid sequential gamma camera scintigraphy in conjunction with computer aided storage and evaluation of data has been shown to be a promising method for the analysis of CSF dynamics in man. 2. Using this method rapid flow of CSF in the basal cisterns can be studied. The further course of tracer activity ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405983
更新日期:1977-01-01 00:00:00
abstract::The results of 16 cases of temporal bone resection were evaluated. The resections, 12 of which were total and 4 partial, had mostly been performed for squamous cell carcinoma invading the temporal bone. Five patients in whom the intervention was considered radical and not followed by irradiation, were alive and well 9...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400676
更新日期:1991-01-01 00:00:00
abstract::We present a case of recurrent metastatic brain tumour spread across a cranial fixation device. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1369-9
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Surgical intervention for unruptured intracranial aneurysms (IAs) carries inherent health risks. The analysis of "patient-specific" IA geometric and computational fluid dynamics (CFD) simulated wall shear stress (WSS) data has been investigated to differentiate IAs at high and low risk of rupture to help cli...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04616-y
更新日期:2020-10-17 00:00:00
abstract::In a proportion of small acoustic neuroma patients, monitoring with magnetic resonance imaging shows no volumetric increase of tumour size over the years. The object of the study was to identify some indications for the clinical choice between immediate surgery (with the related risks) and watchful waiting. We perform...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050483
更新日期:1999-01-01 00:00:00
abstract::Tumour associated epilepsy (TAE) is a poorly understood manifestation of many gliomas, meningiomas and metastatic brain tumours that has important clinical and social implications. Etiological mechanisms underlying tumour associated epilepsy include theories invoking peritumoural amino acid disturbances, local metabol...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s007010050001
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:The frontal bridging vein, which is the venous drainage route of the frontal cortex into the superior sagittal sinus (SSS), sometimes poses an obstacle in the anterior interhemispheric approach during surgery for anterior cerebral artery aneurysms. Although severe complications including venous infarction or...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3285-y
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Side-to-side neurorrhaphy may protect the denervated end organ and preserve the initial connection with proximal stump. We examined the effect of protective side-to-side anastomosis on nerve and end organ regeneration in proximal nerve injury model. METHODS:The left common peroneal nerve of 24 Sprague Dawle...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03835-2
更新日期:2019-04-01 00:00:00
abstract::Without mortality, 31 patients underwent conservative treatment for traumatic supratentorial acute subdural haematoma (SDH). Later on six of them had the haematoma surgically evacuated mainly because of a deterioration of the Glasgow Coma Scale (GCS) scores. It was found that patients with a midline shift of less than...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02307412
更新日期:1995-01-01 00:00:00
abstract::We describe two cases of clinical and radiographic vasospasm after transsphenoidal resection of a craniopharyngioma. We review the literature on the association of vasospasm and craniopharyngioma and examine management options. Given the lack of evidence for the optimal management of these patients, treatment in conco...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2956-4
更新日期:2016-11-01 00:00:00
abstract:PURPOSE:To analyse the intraoperative complications of a single neurosurgeon, with emphasis on devastating intraoperative incidents, and how they possibly could have been avoided. METHODS:All the patients operated upon by the author between 1986 and 2002, i.e. 252 patients with 270 craniotomies for 294 aneurysms, were...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0452-9
更新日期:2009-09-01 00:00:00
abstract::To clarify the value of clinical long-term follow-up with radiological examination, ranging from 12 to 63 months (average: 35 months), 18 consecutive patients suffering from spontaneous carotid cavernous fistula (CCF), were studied prospectively. Five aged patients without aggressive symptoms were treated conservative...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050059
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:Cranial nerves (CNs) crossing between the brainstem and skull base at the level of the tentorial hiatus may be at risk in temporomesial surgery involving subpial dissection and/or tumorous growth leading to distorted anatomy. We aimed to identify the surgical steps most likely to result in CN damage in this t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-0987-4
更新日期:2011-06-01 00:00:00
abstract::As an alternative to the gauze often used on scalp incisions, we prepared a pad made of non-woven sheets, coated with adhesive on one side. Unlike conventional gauze, the pad did not slip away from the incision line or become entangled with the scalp clips, thus demonstrating its high usefulness for this purpose. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411309
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Percutaneous trigeminal nerve rhizotomy is usually performed by free-handed puncture of the foramen ovale under radiographic control with the patient kept semiconscious. The procedure has thus been reported to be highly uncomfortable for both the patient and surgeon. To our knowledge, this is the first descr...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03859-8
更新日期:2019-05-01 00:00:00
abstract::Three patients with symmetrical bilateral low-density areas which were the perfusion territories of Heubner's arteries are reported. The infarctions were demonstrated on computed tomography after aneurysm surgery. Two of them had an anterior communicating artery aneurysm and the other one had multiple aneurysms of bot...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01418830
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:We verified the effectiveness of training in endoscopic endonasal transsphenoidal surgery (eETSS) techniques using chicken eggs and a skull model. METHODS:We verified the area of eggshell removed by drilling when five residents and four experts used the chicken eggs and a skull model. RESULTS:When resident...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2035-7
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVES:Optimal selection of idiopathic normal pressure hydrocephalus (iNPH) patients for shunt surgery is challenging. Disease State Index (DSI) is a statistical method that merges multimodal data to assist clinical decision-making. It has previously been shown to be useful in predicting progression in mild cogniti...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2980-4
更新日期:2016-12-01 00:00:00
abstract::When operating on a child with a large myelomeningocele and kyphosis, coverage with skin of high quality and a supporting layer of subcutaneous tissue can be difficult. The dermal circulation in the newborn is finite and an extensive mobilisation of the skin is a risky venture. Between 1988 and 2003 five children with...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0704-2
更新日期:2006-03-01 00:00:00
abstract::Early diagnosis of thoracic disc herniations has become more common with the advent of spinal magnetic resonance imaging (MRI). This early diagnosis combined with choosing the optimal surgical approach, to ensure adequate decompression without excessive cord and root manipulation, will achieve the optimum results. It ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01402509
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:The evolution of pituitary surgery has made it a safe and effective form of treatment; however, risks of inadequate tumor resection, cerebrospinal fluid (CSF) leak, pituitary dysfunction, and vascular injury still exist. The use of intraoperative ultrasonography (IOUS) in pituitary surgery has been well desc...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04674-2
更新日期:2021-01-05 00:00:00
abstract:BACKGROUND:Neurogenic pulmonary edema (NPE) is a clinical syndrome characterized by the acute onset of pulmonary edema after a significant central nervous system (CNS) insult. NPE occurs as a result of release of catecholamines into the blood immediately after aneurysm rupture. The aim of this study is to investigate t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3091-6
更新日期:2017-04-01 00:00:00
abstract::Indirect carotid-cavernous sinus dural arterio-venous fistulae (cDAVF) can be treated by transarterial and/or transvenous embolisation. This study evaluated patients with cDAVF who underwent transvenous embolisation using the direct superior ophthalmic vein (SOV) approach. Between January 2004 and October 2006, eight ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-1573-2
更新日期:2008-06-01 00:00:00
abstract::Extensive large dumbbell-shaped hypoglossal schwannoma is extremely rare, and total resection is nearly impossible. We present a case of a 61-year-old male with a giant-size hypoglossal schwannoma with moderate tongue atrophy. The tumor extended from the enlarged hypoglossal canal to the brainstem intradurally and the...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3431-6
更新日期:2018-04-01 00:00:00
abstract::Arachnoid cysts are developmental anomalies that represent 1% of all intracranial space occupying lesions. Treatment of symptomatic cases may include shunting of the cyst or an open fenestration of it, among other less acceptable surgical procedures. Each procedure has its own pros and cons. We present a case of the d...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-010-0658-x
更新日期:2010-08-01 00:00:00
abstract::Symptomatic extracranial vertebral artery (VA) dissection may need surgery. We describe such a case successfully treated with atlantoaxial fusion based on its rare dynamic angiographic findings. A 27-year-old woman suffered from repeated brainstem and cerebellar infarctions from a left extracranial VA dissecting aneur...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-016-2891-4
更新日期:2016-09-01 00:00:00
abstract::In 40 postmortem specimens the cervical posterior roots were examined under the surgical microscope, and intradural communicating fibres between neighbouring segments were demonstrated. The implications of these frequent variants for the diagnosis of prolapsed cervical discs are discussed. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400951
更新日期:1980-01-01 00:00:00