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 included. All intraoperative events that possibly could have influenced the clinical outcome were recorded prospectively. RESULTS:A total of 16 cases (6.3% of all the patients) with serious intraoperative incidents were identified. In 11 cases (3.6% of all aneurysms), an intraoperative rupture occurred that was judged to have had mild to severe consequences for the patient. In another four patients (1.6% of all patients), all with unruptured, large aneurysms (>15 mm) of the carotid or middle cerebral arteries, a major vessel occlusion occurred inadvertently. In one patient with a large, unruptured MCA aneurysm, a clip slipped after the closure of the wound, causing a fatal intracerebral haemorrhage. These events had a severe impact on the clinical outcome. In retrospect, most of these incidents could, and should have, been avoided. CONCLUSIONS:It is recommended to start the training of new aneurysm surgeons on patients with small, supratentorial, unruptured aneurysms, followed by ruptured aneurysms in all other supratentorial locations than the anterior communicating artery (ACOM), which is the supratentorial location that should be the last step in the training of independent aneurysm surgeons.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Wester Kdoi
10.1007/s00701-009-0452-9subject
Has Abstractpub_date
2009-09-01 00:00:00pages
1013-24issue
9eissn
0001-6268issn
0942-0940journal_volume
151pub_type
杂志文章abstract：:The superficial middle cerebral veins (SMCVs) are large veins to drain the brain and therefore anatomical knowledge of them is important for neurosurgeons and neuroradiologists. In a patient with a ruptured blister aneurysm, we incidentally found during angiography an aberrant drainage of the SMCVs, which penetrated t...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-019-03838-z
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:In patients with mass lesions near "eloquent" cortical areas different preoperative mapping techniques can be used. Two of the most widely used approaches include positron emission tomography (PET) and functional MRI (fMRI). We employed both methods in the same patients undergoing presurgical evaluation and ...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-002-0992-8
更新日期：2002-09-01 00:00:00
abstract：:In this paper the results of measurements of ultrasound velocity in, and density of, a number of normal and pathological tissues are given. From the results it can be concluded that intracranial pathological regions will often be detectable with ultrasound techniques, but is is not possible with any degree of certaint...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01809169
更新日期：1979-01-01 00:00:00
abstract：INTRODUCTION:Stereotactic radiosurgery (SRS) is increasingly used as a minimally invasive alternative in many neurosurgical conditions, including benign and malignant tumors, vascular malformations, and functional procedures. As for any surgical procedure, strict safety guidelines and checklists are necessary to avoid ...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-019-03843-2
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:The type of paraclinoid aneurysm has been used to decide management methods. Our aim was to assess the relation of the types of paraclinoid aneurysms and outcomes after endovascular treatment and the efficiency of present endovascular techniques. METHODS:A retrospective analysis was performed on patients wi...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-013-1830-x
更新日期：2013-11-01 00:00:00
abstract：:This case illustrates the correlation between Magnetic Resonance Imaging (MRI) and the pathological findings in a case of cavernous sinus (CS) aspergilloma. ...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-004-0449-3
更新日期：2005-03-01 00:00:00
abstract：:For treatment of spasmodic torticollis (s.T.) microsurgical decompression of the intraspinal-intracranial portion of the accessory nerve (a.N.) has been performed in 11 patients with proved neurogenic lesions of the accessory nerve-dependent muscles. Neurogenic lesions were discovered by meticulous electromyographic (...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01406346
更新日期：1981-01-01 00:00:00
abstract：:In 17 primary transnasal operations on Nelson tumours long-term results are assessed measuring ACTH plasma levels and performing regular neuroradiological controls. In small intrasellar adenomas only one recurrent ACTH elevation near to pretreatment levels without symptoms from tumour growth was observed after 10 year...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01405437
更新日期：1982-01-01 00:00:00
abstract：:Cell-mediated cytotoxicity (CTX) of meningioma patients towards meningioma cells and fibroblasts was studied in vitro before and after surgery, using the 3H-proline microcytotoxicity test. When incubated with allogeneic target cells before surgery, lymphocytes from three out of seven donors showed a specific destructi...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01808518
更新日期：1979-01-01 00:00:00
abstract：:Two cases of rupture of intracranial aneurysms and opacification of the lateral ventricles occurring during carotid angiography are reported and X-rays of the haemorrhage from the aneurysms are presented. Though the possibility of this complications remains a real one, the early use of this valuable procedure should n...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01406041
更新日期：1984-01-01 00:00:00
abstract：BACKGROUND:The visualization of any morphological volume (i.e. CT, MRI) together with an additional second morphological volume (i.e. CT, MRI) or functional data set, which may come from SPECT or PET, is a new method for treatment planning, verification and follow-up of interstitial irradiation. METHOD:The authors pre...
journal_title：Acta neurochirurgica
pub_type： 临床试验,杂志文章
doi：10.1007/s007010070022
更新日期：2000-01-01 00:00:00
abstract：PURPOSE:The medial tentorial artery (MTA) of Bernasconi-Cassinari has been associated with many neurosurgical pathologies, including tentorial and petroclival meningiomas, dural arteriovenous fistulae, hemangioblastomas, moyamoya disease, arteriovenous malformations, trigeminal neuromas, and malignant gliomas. This ves...
journal_title：Acta neurochirurgica
pub_type： 杂志文章,评审
doi：10.1007/s00701-011-1195-y
更新日期：2011-12-01 00:00:00
abstract：:A case of spontaneous temporal pneumatocoele secondarily infected by Haemophilus parainfluenzae is reported. Its relation to the lateral ventricle and to a defect in the tegmen tympani was confirmed by computerized tomography (CT). The possible aetiological mechanisms are discussed. ...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01808962
更新日期：1979-01-01 00:00:00
abstract：:The ES is a non-physiological stimulus of the brain. However it represents an important and indispensable part of stero-EEG investigation since it is an easily adjustable method, capable of inducing typical electro-clinical seizures. From the clinical and electrical responses elicited by ES and from the data of the st...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/978-3-7091-8444-8_4
更新日期：1976-01-01 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：:Leptomeningeal spread and hydrocephalus are increasingly recognized as late disease complications of glioblastoma with almost a quarter of patients requiring early cerebrospinal fluid shunting. The neurosurgeon is challenged with maintaining shunt patency when tumor disease progression is rapid and adjuvant oncologic ...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-018-3509-9
更新日期：2018-05-01 00:00:00
abstract：:The growth of a small arteriovenous angioma over a period of almost 18 years in a 20 year old patient has been proved by arteriography. This case is added to 29 cases previously published in the literature. The authors do not readily accept the theory of autochthonous growth, but prefer secondary or "pseudo-growth". I...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01405394
更新日期：1977-01-01 00:00:00
abstract：:Maurice Ravel (1875-1937), the great impressionist-classicist composer of many popular compositions, such as the Boléro, suffered from a progressive disease and died following an exploratory craniotomy by Clovis Vincent. The history of his progressive dementia and the contribution of a car accident, following which he...
journal_title：Acta neurochirurgica
pub_type： 传,历史文章,杂志文章
doi：10.1007/s00701-009-0507-y
更新日期：2010-04-01 00:00:00
abstract：AIM:To study the value of early (24 h) post-operative ACTH and serum cortisol as predictors of remission after transsphenoidal surgery in Cushing's disease. METHODS:We prospectively studied 44 patients who underwent transsphenoidal surgery for Cushing's disease between 1997 and 2005. The mean follow-up period of patie...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-007-1133-1
更新日期：2007-01-01 00:00:00
abstract：BACKGROUND:Complications of and insertion depth of the Codman MicroSensor ICP monitoring device (CMS) is not well studied. OBJECTIVE:To study complications and the insertion depth of the CMS in a clinical setting. METHODS:We identified all patients who had their intracranial pressure (ICP) monitored using a CMS devic...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-013-1856-0
更新日期：2013-11-01 00:00:00
abstract：:Fifteen cases of large thalamic gliomas were treated by laser surgery and CUSA under X8 magnification and subsequently they were subjected to radiotherapy. More than 50% of the tumours were located in the dominant hemisphere and therefore an interhemispheric approach was carried out to avoid disturbances of speech and...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01418796
更新日期：1985-01-01 00:00:00
abstract：:This article will look at how one female neurosurgeon in Turkey made her mark in the field. In 1954, Dr. Aysima Altinok began her residency training in neurosurgery at Haydarpaşa Numune Hospital where the first official department of neurosurgery in Turkey had been founded five years earlier. On November 22, 1959, she...
journal_title：Acta neurochirurgica
pub_type： 传,历史文章,杂志文章
doi：10.1007/s00701-007-1252-8
更新日期：2007-01-01 00:00:00
abstract：:Myelocystoceles are rare lesions. Rarer still are thoracic myelocystoceles. Two patients with thoracic myelocystoceles are being reported. The first patient presented with swelling in the thoracic region with paraplegia and incontinence. MR with MR myelography revealed the malformation to be a thoracic myelocystocele....
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-006-0734-4
更新日期：2006-07-01 00:00:00
abstract：BACKGROUND:The exact aetiology, growth and rupture of intracranial aneurysms is unclear. In this study we investigated a possible association between intracranial aneurysm rupture and polymorphism of the endothelial nitric oxide synthase gene G894T. METHODS:Endothelial nitric oxide synthase gene polymorphism of 53 pat...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-007-1467-8
更新日期：2008-01-01 00:00:00
abstract：:A new atraumatic method for patency and blood flow control of microvascular anastomoses has been developed. Sounds proximal and distal to a suture line are separately detected by means of two specially modified miniature microphones built together as an auscultation unit and named a diplo-microphone. Transmission of t...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF02074518
更新日期：1980-01-01 00:00:00
abstract：BACKGROUND:The best care and management of patients in persistent vegetative state (PVS) has been the subject of sustained moral and legal debate for a number of years. However, the views of specialist doctors in Belgium involved in the care for patients in PVS are largely unknown. METHODS:A postal questionnaire was s...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s007010050129
更新日期：1998-01-01 00:00:00
abstract：BACKGROUND:Studies of deep brain stimulation (DBS) in mice are rare due to their small size, agility, aversion to handling, and high anxiety compared to larger species. Studying DBS modulation of neural circuitry in murine models of human behavior may ensure safety, guide stimulatory parameters for clinical trials in h...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-014-2062-4
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:Supratentorial intracerebral haemorrhage (ICH) carries an excessive mortality and morbidity. Although surgical ICH treatment can be life-saving, the indications for surgery in larger cohorts of ICH patients are controversial and not well defined. We hypothesised that surgical indications vary substantially a...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-019-03853-0
更新日期：2019-05-01 00:00:00
abstract：:Serpentine aneurysms of the posterior cerebral artery (PCA) treated by the internal maxillary artery (IMA) bypass are rare. Here, the authors report the case of a 34-year-old male patient who presented with a half-year history of gradual severe headache and right-sided limb monoparesis and paresthesia lasting for 1 we...
journal_title：Acta neurochirurgica
pub_type： 杂志文章,评审
doi：10.1007/s00701-019-03902-8
更新日期：2019-06-01 00:00:00
abstract：:12 patients, 10 women and 2 men, were operated on for removal of a jugular foramen neurinoma. Removal was total in 11 cases and operative mortality was 16.6%. As there are no clinical or instrumental signs that permit sure distinction between these tumours and those of the cerebellopontine angle, only a thorough radio...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01406293
更新日期：1975-01-01 00:00:00
