Abstract:
BACKGROUND:Even in specialized centers, suboptimal aneurysm clipping can be as high as 12%. Intraoperative fluorescence angiography with indocyanine green and, more recently, fluorescein sodium have been shown to be a good method for intraoperative flow assessment. However, the cost with the apparatus it entails limits its widespread use. We have developed a low-cost universal fluorescence module (FM) designed to visualize fluorescein and perform intraoperative angiography. The purpose of this paper is to describe this device as well as to present our early experience with its use in the treatment of cerebral aneurysms. METHOD:A FM was designed and built using a cyan-blue narrow bandpass (460 to 490 nm) excitation filter and a yellow-orange longpass (blocking wavelengths under 520 nm) barrier filter mounted on a 3D-printed holding tray in a specific disposition to perfectly match the light source and the objective lens of the surgical microscope. It allowed switching from white light to fluorescence mode in a simple and sterile fashion. Its perfect attachment to the microscope was possible by reusing the lens fittings extracted from used original drape sets that would otherwise be discarded. Four patients underwent aneurysm clipping using the FM at two institutions from April to September 2018. RESULTS:A bright green fluorescence against a dark background was observed after intravenous bolus of fluorescein. Blood vessels became obviously distinct from non-contrast-filled structures such as clipped aneurysms and the brain. Vascular anatomy could be appreciated without any distortion, including perforating arteries. CONCLUSIONS:Intraoperative fluorescence angiography was successfully performed with the use of this universal FM after intravenous injection of fluorescein sodium. This simple and low-cost device may be useful in resource-limited centers, where other sorts of intraoperative angiography are not available.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Leal RTM,Fernandes RA,Escudeiro GP,Rodrigues RMC,Monteiro R,Landeiro JAdoi
10.1007/s00701-019-03904-6subject
Has Abstractpub_date
2019-07-01 00:00:00pages
1343-1348issue
7eissn
0001-6268issn
0942-0940pii
10.1007/s00701-019-03904-6journal_volume
161pub_type
杂志文章abstract::Four cases of primary intraosseous meningiomas were seen among 373 cases of intracranial meningiomas operated upon in the Neurosurgical Clinic of the Krankenhaus Nordstadt, Hannover, FRG between January 1978 and December 1988. These 4 cases represent 1% of all intracranial meningiomas. Patients' age ranged between 21 ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01402613
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Data regarding long-term outcomes following surgery for cauda equina syndrome (CES) is scarce. In addition, these studies rely on patient descriptions of the presence or absence of symptoms, with no gradation of severity. This study aimed to assess long-term bladder, bowel, sexual and physical function using...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03973-7
更新日期:2019-09-01 00:00:00
abstract::In this study, which comprises 144 consecutive head injuries, the initial clinical assessment and the findings of the initial CT scan are related to the outcome. The mortality is related to the patient's level of consciousness and pupillary light reflex on admission. The disability rate (= number of disabled/number of...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405444
更新日期:1982-01-01 00:00:00
abstract::In Europe only few neurosurgeons are trained in both open surgical clipping as well as in endovascular techniques for treatment of intracranial aneurysms. To investigate the safety and efficacy of performing both techniques we, two dual trained neurosurgeons, analyzed our results in repairing ruptured intracranial ane...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2101-1
更新日期:2014-07-01 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:PURPOSE:Oculomotor nerve palsy (ONP) occasionally occurs in cases of pituitary apoplexy (PA) associated with pituitary adenoma, but its mechanism remains unclear. Intracranial nerves are clearly visualized by fast-imaging employing with steady-state acquisition (FIESTA). Here, we assessed the oculomotor nerve compressi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04632-y
更新日期:2021-02-01 00:00:00
abstract::A total of 160 patients suspected of having acquired hydrocephalus were studied either by quantitative isotope ventriculography (QIV) or by lumbar isotope cisternography (LIC). Of these patients, 56 had hydrocephalus. Mental deterioration, gait disturbances, ataxia, spasticity, and incontinence were most frequently pr...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01407686
更新日期:1979-01-01 00:00:00
abstract::The authors report the results of a study designed to compare the effectiveness of two different types of radiation in patients with acromegaly where surgical therapy had failed to normalize growth hormone (GH). Longterm follow-up after conventional high voltage radiation in 17 patients and proton therapy in 13 patien...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01403492
更新日期:1989-01-01 00:00:00
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 c...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0356-8
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Multicentric WHO grade II gliomas constitute a rare entity. Their pathogenesis and treatment are still a matter of debate. OBJECTIVE:We present a 23 year-old female with two synchronous but separate WHO grade II oligodendrogliomas in the temporal and frontal lobes. CLINICAL FEATURES:The two lesions showed ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0306-5
更新日期:2009-12-01 00:00:00
abstract::In anaesthetized artificially ventilated dogs, the effect of graded arterial hypoxaemia on cerebral blood flow (CBF) and on the oxidative carbohydrate metabolism of the brain was tested. It is shown that the hypoxic vasodilatory influence on cerebral vessels is present even at moderate systemic hypoxaemia, provide tha...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01886665
更新日期:1976-01-01 00:00:00
abstract:BACKGROUND:Accumulating results have disclosed that early brain injury (EBI) may play a major role in the determination of the outcome of aneurysmal subarachnoid hemorrhage (SAH) patients. This study is of interest to examine the efficacy of pitavastatin, a 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase) ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2399-3
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Vascular Endothelial Growth/Permeability Factor (VEG/PF) has been correlated with angiogenesis and vascular leakage in diverse pathological conditions of the brain. On the other hand, neoformation of capillaries and vascular hyperpermeability have been related to progressive enlargement of chronic subdural h...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010200047
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:We developed a new simple therapeutic method for the treatment of chronic subdural hematoma (CSDH) without irrigation and drainage. This method is characterized by replacement of the hematoma with oxygen. METHODS:Seventy patients (seventy-eight sides) with CSDH were treated with this method from May 1994 to...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0689-x
更新日期:2006-05-01 00:00:00
abstract::Arrested hydrocephalus probably results from improvement of CSF circulation during growth. Although a generally accepted condition, its mode of onset, its presence in a given patient, and time required to establish the absence of progressive hydrocephalus have not been defined. Five patients are presented with ostensi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01809223
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVE:Pure pineal germinomas have been rarely reported in girls. Gender incidence and differences of pure pineal germinomas are not well known. The authors report a series of pure pineal germinoma and its gender characteristic is reviewed. METHODS AND RESULTS:Of a total of 50 germ cell tumors operated on between 1...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-006-0846-x
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Vaccination against tumour-associated antigens is one approach to elicit anti-tumour responses. We investigated the effect of polynucleotide (DNA) vaccination using a model antigen (E. coli lacZ) in a syngeneic gliosarcoma model (9L). METHODS:Fisher 344 rats were vaccinated thrice by intramuscular injection...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-012-1526-7
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Schwannomas occur sporadically or in association with neurofibromatosis 2 (NF2), an autosomal dominant disorder, which predisposes to multiple schwannomas, meningiomas and spinal ependymomas, with bilateral vestibular schwannomas as the classic hallmark. As NF2 and sporadic schwannomas differ in some respect...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010070036
更新日期:2000-01-01 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:Wound healing impairment is a serious problem in surgical disciplines which may be associated with chronic morbidity, increased cost and patient discomfort. Here we aimed to investigate the relevance of bacterial colonisation on suture material using polymerase chain reaction (PCR) to detect and taxonomicall...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3404-9
更新日期:2018-03-01 00:00:00
abstract::This paper is based on a study of sixty cases of cranio-cerebral erosion treated in the Department of Neurosurgery. All India Institute of Medical Sciences, New Delhi during the last 20 years. This constitutes the largest series, so far reported from anywhere. It has provided a unique opportunity to get a comprehensiv...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/BF01400508
更新日期:1987-01-01 00:00:00
abstract::The authors review the literature and present 8 cases of extradural haematoma of the posterior fossa operated from 1979 to 1985 at the Neurosurgical Clinic of the University of Pavia. Emphasis is placed on the importance of an early diagnosis of the symptoms which are often ignored due to the absence of specific clini...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01809553
更新日期:1986-01-01 00:00:00
abstract::A 28-year-old man with genetically confirmed hyperostosis corticalis generalisata (Van Buchem disease) suffered from headache and progressive cognitive and sensibility disorders. Bone formation of the skull was ongoing, leading to narrowing of the intracranial space and foramen magnum. A large bilateral frontoparietal...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2445-1
更新日期:2015-07-01 00:00:00
abstract::In human brain tumours the extension of peritumoural brain oedema may vary considerably. 37 brain tumours of various pathology and 2 abscesses were examined to identify the factors and mechanisms responsible for the oedema spreading. Peritumoural oedema profiles were determined towards the white matter and ventricle b...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01793077
更新日期:1988-01-01 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::Immunohistochemical staining for proliferating cell nuclear antigen (PCNA) and BrdU using anti-PCNA and anti-BrdU monoclonal antibodies, respectively, was performed in 16 human brain tumours, including 3 glioblastomas multiforme, 2 anaplastic astrocytomas, 1 cerebellar astrocytoma, 2 recurrent meningiomas, 4 non-recur...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400617
更新日期:1992-01-01 00:00:00
abstract::The anterior choroidal artery (A.ch.a.) was studied in 140 hemispheres of the human brain. In 50 specimens the artery was cannulated and perfused with acrylic resin, in 20 specimens the A.ch.a., was selectively cannulated and perfused with dye. The artery then was microsurgically dissected and photographically documen...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401968
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Hyponatremia generally occurs after transsphenoidal surgery (TSS) in a delayed fashion. Most patients with delayed postoperative hyponatremia (DPH) are asymptomatic or only express non-specific symptoms; consequently, DPH is associated with prolonged hospitalization. No consensus has been reached on which pa...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03818-3
更新日期:2019-04-01 00:00:00
abstract::General aspects of glioblastomas are considered such as preoperative diagnosis, stereotactic punctures for tissue samples, location and tumour size, interference with CSF circulation. The operative risk and different approaches to treatment are discussed, and the results are compared. The described combined treatment ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406638
更新日期:1978-01-01 00:00:00
abstract::In the present study the variation of the localisation and the course of the coronal suture (CS) was examined on the lateral skull X-ray. The study shows a variation of the localisation and course of the CS from the average position within +/- 4 mm in 65-77% and extreme differences between minimum and maximum values b...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01560378
更新日期:1987-01-01 00:00:00