Abstract:
BACKGROUND:Transsphenoidal surgery has been well established as an effective primary treatment for tumours of the sellar region. During the dural opening, the prominent intercavernous sinus poses limitations for this approach and may contribute to incomplete tumour resections. METHOD:Based on our experience from 940 cases of conventional transsphenoidal surgery, we have developed a stepwise protocol for achieving bleeding control in 72 cases (7.7%) that had prominent anterior intercavernous sinus. FINDINGS:A custom-made 45-degree right- or left-angled bipolar coagulator (38 cases) or Landolt bipolar coagulator (29 cases; Aesculp, Tuttlingen, Germany) was inserted into the small dural opening, and both of the dural layers were coagulated together so that the potential space between the endoosteal layer and meningeal layer could be sealed, and the dural opening could be extended. When the anterior portion of the medial wall of the cavernous sinus was accidentally opened, we then placed a small piece of oxidised regenerated cellulose (Surgicel; Johnson & Johnson, North Yorkshire, UK) at the opening of the medial wall of the cavernous sinus and coagulated both dural layers together starting from the sellar floor side with a custom-made 45-degree angled bipolar coagulator. For the relatively large opening of the cavernous sinus, a microfibrillar collagen haemostat (Avitene; MedChem Products, Woburn, MA) or fleece-coated fibrin glue (TachoComb; Nycomed Austria, Linz, Austria) patch was applied over the opened cavernous sinus with gentle compression and was found to be effective in most cases. Rarely, direct suture of the opened medial wall of the cavernous sinus was necessary in five cases. CONCLUSIONS:We describe a stepwise approach to overcome unusual bleedings from the prominent intercavernous sinus during conventional transsphenoidal surgery. Our surgical experience reveals that these methods can be very effective for the control of sinus bleeding.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Kim EH,Ahn JY,Chang JH,Kim SHdoi
10.1007/s00701-009-0356-8subject
Has Abstractpub_date
2009-07-01 00:00:00pages
803-8issue
7eissn
0001-6268issn
0942-0940journal_volume
151pub_type
杂志文章abstract:BACKGROUND:Brainstem cavernous malformations (CM) carry high risks of hemorrhage and neurologic morbidity. While much is published on physical effects of brainstem CM, very little is known about these patients' quality of life. This study aimed to assess the quality of life PROMIS-29 health domains of brainstem CM pati...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-04075-0
更新日期:2019-12-01 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::The clinical findings and operation results in two series of patients with medial prolapse of an intervertebral disc with total or partial occlusion of the spinal canal are reported. In one of the series (30 patients) symptoms of cauda equina compression, with bladder and rectal disturbances, were present, and in the ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405333
更新日期:1978-01-01 00:00:00
abstract:BACKGROUND:Cerebral vasospasm following subarachnoid haemorrhage (SAH) remains one of the major factors contributing to poor overall patient outcome. Prostaglandin F2-alpha (PGF2a) induces vasoconstriction. After SAH, PGF2a leads to cerebral inflammation and enhanced vasoconstriction, resulting in cerebral vasospasm. L...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3419-2
更新日期:2018-02-01 00:00:00
abstract::Retroclival arachnoid cysts are rarely reported. A 40-year-old woman had a sudden onset of occipitocervical pain. Magnetic resonance imaging (MRI) revealed a cystic mass lesion located in the retroclival region and complicated with intracystic haemorrhage. At operation, by a right lateral suboccipital approach, an old...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0381-7
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND AND AIMS:The aim of the present study was to evaluate the interest of systematic post-operative CT scan after unilateral chronic subdural hematoma (CSDH) evacuation. To achieve this goal, we chose to evaluate the ability of post-operative CT scan to predict the most frequent complication of CSDH: hematoma re...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2820-6
更新日期:2016-07-01 00:00:00
abstract::The purpose of this study was to evaluate the high resolution magnetic resonance angiography (MRA) as pre-operative angiography for the detection of ruptured cerebral aneurysms. MRA was performed on 1.5 tesla system using the 3-dimensional time of flight (3D-TOF) method. The field of view was 16 cm or 20 cm and matrix...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400663
更新日期:1994-01-01 00:00:00
abstract::In 135 cases of posterior fossa surgery almost exclusively in the cerebellopontine angle (CPA) intraoperative monitoring of brain-stem acoustic evoked potentials (BAEP) and partly somatosensory evoked potentials (SEP) was performed. The series consisted of 20 microvascular decompressions, 63 acoustic neurinomas, 7 vas...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01407170
更新日期:1989-01-01 00:00:00
abstract::After clipping of intracranial aneurysms, postoperative vasospasm may occur remote from the distribution area of the artery and may cause death. The authors report two cases and give the clinical, neuroradiological, and neuroanatomical findings. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01773115
更新日期:1978-01-01 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:BACKGROUND:Z-L response (ZLR) has been suggested to a new electromyographic (EMG) potential recorded from the facial muscle of patient with hemifacial spasm (HFS) during microvascular decompression (MVD). Although ZLR has been suggested to be useful, experience of ZLR monitoring is limited and its significance during M...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3462-z
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Lumbar disc disease is a very common condition with a substantial socioeconomic impact. Studies have shown the importance of a multilevel assessment of this disease, as its course is influenced by many factors. Most follow-up studies use the degree of physical impairment to measure the outcome of a certain t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1114-4
更新日期:2007-08-01 00:00:00
abstract::Over the past 5 years 9 patients underwent partial or complete corpus callosotomy for treatment of medically intractable epileptic seizures. A beneficial effect of the procedure was observed in 8 patients. Criteria for performance of the procedure included CT evidence of unilateral cerebral damage and non-localized ep...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406608
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Specific microanatomical characteristics of the trigeminal nerve root (TNR) blood supply and close neurovascular relationships with surrounding vessels as well as their possible clinical significance were the main reasons for this study. METHOD:The vasculature of 25 adult and four fetal TNRs were microdisse...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0913-1
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:While large-to-giant pituitary adenomas (PAs) may be safely removed by experienced surgeons through a single route, the procedure is technically challenging. We present the outcome of a simultaneous combined transcranial and transsphenoidal approach and discuss its applications. METHODS:A retrospective revi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-1029-y
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Middle cerebral artery (MCA) aneurysms are among the more challenging aneurysms for endovascular treatment. We report a contemporary 5-year experience with endovascular therapy for MCA aneurysms at a high-volume neurovascular center. METHODS:Review of prospectively maintained intracranial aneurysm database....
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-012-1594-8
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To analyze prospectively the frequency and the risk of symptomatic and asymptomatic haemorrhage after image guided stereotactic biopsy of intra-axial brain tumours. METHODS:The study was conducted within a time frame of 24 months (April 1998-April 2000). 326 patients (150 males, 176 females; mean age 56.8 ye...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010170058
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:According to recent findings, diffusion tensor tractography (DTT) only allows prediction of facial nerve location in relation to vestibular schwannoma (VS) with high probability. However, previous studies have not mentioned why only the facial nerve was selectively visualized. Our previous report investigate...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2411-y
更新日期:2015-06-01 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
abstract::One hundred and fifty patients with trigeminal neuralgia were treated by percutaneous compression of the Gasserian ganglion (PCGG) during the last 8 years. The technique is the one described by Mullan with the balloon inflated during 6 minutes with 0,7 cc of contrast medium. Over a follow-up period ranging from 6 mont...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411438
更新日期:1995-01-01 00:00:00
abstract::The neural activity pattern of the subthalmic nucleus (STN) was investigated in five patients with Parkinson's disease who were scheduled for electrode implantation for chronic stimulation of the STN. The initial target was placed 8 mm or 10 mm lateral to the midline, 3 mm to 4 mm posterior to the midcommissural point...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050251
更新日期:1998-01-01 00:00:00
abstract::Arachnoid cysts are frequent anomalies of the CNS. They are benign lesions within the arachnoid membrane and have been reported to occur in virtually all locations where arachnoid is present. An intraventricular location, however, is rare and occurrence within the fourth ventricle is particularly uncommon. The first r...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-009-0309-2
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:In contrast to other regions of the human spine, dorsal fixation with rods and pedicle screws is comparatively rarely performed in the cervical spine. Although this technique provides a higher mechanical strength than the more frequently used lateral mass screws, many surgeons fear the relatively high rate o...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0447-6
更新日期:2010-04-01 00:00:00
abstract::Leptomeningeal cysts are commonly seen in children usually following trauma and associated with bulging leptomeninges at the site of fracture. Intradiploic leptomeningeal cyst is an important differential for an expansile lytic lesion in the bony calvarium especially in a patient with a previous history of trauma. Her...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2660-9
更新日期:2016-02-01 00:00:00
abstract::Octreotide is a potent agonist of somatostatin that lowers the serum level of growth hormone (GH), and reduces the size of somatotropinomas. However, the detailed mechanism of shrinkage of this tumour is not known. We, therefore, evaluated 11 patients with somatotropinomas who were treated with octreotide 300 microgra...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411403
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Tumours of the brachial plexus region are rare and most publications are case reports or studies with a small series of patients. The aim of this study is to present our experience in managing these lesions. METHODS:We review 18 patients with tumours in the brachial plexus region submitted to surgical treat...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0380-8
更新日期:2009-09-01 00:00:00
abstract::The feasibility of diagnosing the malignancy and viability of intraparenchymal brain tumours using Gd-DTPA, enhanced and unenhanced T1-weighted MRIs was investigated. The relationship between the Gd-DTPA enhancement pattern, the growth fraction (GF) determined by using the anti-bromide-oxyuridine (BrdU) monoclonal ant...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400619
更新日期:1992-01-01 00:00:00
abstract::Intraoperative facial nerve monitoring (IFNM) is a suitable technique for intraoperative facial nerve identification and dissection, especially in large vestibular schwannomas (VS) (acoustic neuroma). To evaluate its feasibility for estimating functional nerve outcome after VS resection 60 patients underwent surgery u...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050090
更新日期:1998-01-01 00:00:00
abstract::Subdural collections or hematomas are frequently observed after shunt placement [7-9, 13], but rarely after ETV [6]. A review of literature revealed 7 cases [1, 5, 6, 10, 12], of which only 1 was symptomatic [5]. We will discuss the causes, management, and methods of prevention of this complication and we will present...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0715-z
更新日期:2006-05-01 00:00:00
abstract::Therapy for vasogenic brain oedema (VBE) is still an unsolved problem. Experimental work with the aim of establishing an oncotherapeutic option is presented. VBE is performed by focal freeze injury in rats. Using a stereotactic head holder hypo- or hyperosmolar human serum albumin is administered via the intraventricu...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01412002
更新日期:1997-01-01 00:00:00