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::In 131 cases of craniocerebral trauma it was shown in what respect definite changes in the lungs, demonstrated by clinical course, radiographs and blood gas analyses, occurred in proportion to the severity of the trauma. The causes of these changes were considered and the possibility of complicating the course of the ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405745
更新日期:1976-01-01 00:00:00
abstract::Somatosensory evoked potentials (SEPs) were recorded by stimulating the median nerve at the wrist from the skin and epidural space of the 7th cervical spine in patients suffering from cervical radiculopathy or radiculomyelopathy. The patients were divided into four subgroups according to the severity of the disease. S...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01407454
更新日期:1986-01-01 00:00:00
abstract::Results of measurements in vivo of intracranial pressure obtained with a new telemetric epidural pressure transducer are described. The relations of epidural pressure to ventricular fluid pressure are studied in acute experiments and found to be linear, but variable. The functioning of 18 transducers was studied over ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01769143
更新日期:1979-01-01 00:00:00
abstract::A case of a ruptured aneurysm is presented in which the angiograms did not disclose the sac. Rupture of an aneurysm of the anterior communicating artery was suspected from the distribution of subarachnoid blood on computerized tomography (CT), and the presence of a sac was highly suggestive on magnetic resonance imagi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405281
更新日期:1989-01-01 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:The purpose was to review our experience with the surgical management of brainstem cavernomas (BSCs) and especially the impact of the surgical timing on the clinical outcome. METHOD:We retrospectively reviewed 22 patients harboring a BSC, who underwent 23 procedures. FINDINGS:Surgery was carried out during...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0671-7
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Elbow flexion and shoulder abduction are the primary goals in brachial plexus surgery; however, reinnervation of the triceps is also an objective to be considered, as restoration of elbow extension improves the stabilization of the elbow and can provide a more powerful grasp. This study aims to demonstrate t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-1080-8
更新日期:2011-10-01 00:00:00
abstract::A simple, reliable and cheap device for intra-operative monitoring of the facial nerve during surgery for cerebellopontine angle tumours is presented. It consists of a single use tracheostomy tube with a low pressure air inflatable cuff placed in the mouth of the patient on the side of the tumour, connected by a press...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400638
更新日期:1992-01-01 00:00:00
abstract::Recent studies on prognostic variables and the intensive care of head injuries enabled us to select 64 patients and administer a standard treatment protocol to prevent secondary brain injury. All the patients were in coma with a flexor motor pattern as the best response between 6 and 24 hours after the accident and/or...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01413271
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:To establish the risk of recurrence in patients with chronic subdural hematoma (cSDH) on antithrombotic treatment (AT, i.e., antiplatelets and anticoagulants). Secondary end points were perioperative morbidity and mortality between groups (AT vs. no-AT group) and exploration if timing of resumption of AT trea...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3330-x
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Chronic subdural haematoma (cSDH) is a common disease in neurosurgical practise, especially in elderly patients. This is of growing importance as the number of elderly people in the population is increasing steadily. There are scarce data focussing especially on elderly patients with cSDH. This study intende...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-012-1434-x
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:The relationship of pain relief from a recently presented CT-guided indirect cervical nerve root injection with local anesthetics and steroids to surgical decompression as a treatment for single-level cervical radiculopathy is not clear. This retrospective study aimed to compare the immediate and 6-week post...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2933-y
更新日期:2016-10-01 00:00:00
abstract::In 197 comatose patients transcranial magnetic evoked potentials were registered to investigate the integrity of the pyramidal tract. Findings were compared to somatosensory, visual and auditory evoked potentials. Preservation, abnormalities and absence of evoked potentials were related to survival and non-survival. T...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405136
更新日期:1991-01-01 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:BACKGROUND:Cavernous angiomas are vascular malformations which rarely involve the cavities of the lateral ventricles. Knowledge of the specific clinical and neuroradiological features displayed by these lesions is limited by the scarcity of patients included in the reported series. OBJECTIVE AND METHODS:The aim of thi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-009-0186-8
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Most surgical teams currently consider that endoscopy has become the "gold standard" technique for the transsphenoidal approach to pituitary surgery. Pituitary adenomas are commonly benign tumours and should benefit from the least invasive approach. METHOD:In Foch Hospital, from 2006 to 2020, 2835 patients ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04542-z
更新日期:2020-08-29 00:00:00
abstract:BACKGROUND:An external ventricular drain (EVD) is used to measure intracranial pressure (ICP) and to drain cerebrospinal fluid (CSF). The procedure is generally safe, but parenchymal sequelae are reported as a possible side effect, with variable incidence. We investigated the mechanical sequelae of EVD insertion and th...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3291-0
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:The endoscopic endonasal approach for optic nerve decompression is suited for the management of non-traumatic optic neuropathy but remains underreported, presumably due to transcranial approaches still being favoured at individual centres. METHOD:The optic canal is approached endoscopically and transsphenoi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04476-6
更新日期:2020-09-01 00:00:00
abstract::Analysis of verbal responses to electrical stimulation of the trigeminal ganglion and rootlets has been the only method available so far to localize the electrode tip in the most appropriate trigeminal division or division segment, prior to thermocoagulation during percutaneous treatment for trigeminal neuralgia. A di...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01418517
更新日期:1991-01-01 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 authors report on four unusual cases of chronic adult hydrocephalus extracted from a large personal series of patients with hydrocephalic dementia. A syndrome resembling that of normal pressure hydrocephalus was due to the following aetiologies in these patients: Paget's disease of the skull, unruptured cerebral a...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808923
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:The benefits of surgery for symptomatic spinal metastases have been demonstrated, largely based on series of patients undergoing debulking and instrumentation operations. However, as cancer treatments improve and overall survival lengths increase, the incidence of recurrent spinal cord compression after debu...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,多中心研究
doi:10.1007/s00701-019-04197-5
更新日期:2020-04-01 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:OBJECTIVE:The purpose of this study was to compare the effects of single and dual nerve transfer for the repair of shoulder abduction in patients with upper or upper and middle trunk root avulsion. METHODS:We carried out a retrospective analysis of 20 patients with C5-C6 or C5-C7 root avulsion treated by nerve transfe...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03847-y
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:To determine cerebrospinal fluid (CSF) dynamics and morphology in Chiari I malformation (CMI) and assess the response to surgery of the posterior cranial fossa, we examined midsagittal imaging along with anterior cervical 2-3 (AC2-3), posterior cervical 2-3 (PC2-3), and aqueduct CSF flow hydrodynamics in axi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1958-8
更新日期:2014-04-01 00:00:00
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:BACKGROUND:Microsurgical circumferential stripping of intracerebral metastases is often insufficient in achieving local tumor control. Supramarginal resection may improve local tumor control. METHODS:A retrospective analysis was performed for patients who underwent supramarginal resection of a cerebral metastasis by a...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2405-9
更新日期:2015-06-01 00:00:00
abstract::Twenty operated cases of angiographically unrecognized microaneurysm (AUM) have been analysed with special reference to intra-operative observations and clipping-technique. Among the patients with intracranial aneurysms that the authors' facility has operated upon, the incidence of asymptomatic incidental AUM that was...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808877
更新日期:1997-01-01 00:00:00
abstract::A rare case of primary cerebral abscess due to Nocardia asteroides, and its surgical removal, are described. Postoperative meningitis caused by the same fungi was succesfully cured with sulphadiazine and cycloserine. The nocardial disease, its neurological complications, and therapy are reviewed. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401932
更新日期:1977-01-01 00:00:00
abstract::We retrospectively analysed 13 patients (pts.) treated at the University of Tübingen from 1985 to 1993 to evaluate the results of radiation therapy (XRT) given as an adjuvant to totally or subtotally resected meningiomas. The overall survival was 38% at five years with a probability of relapse of 50% at this time. Rec...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02187764
更新日期:1995-01-01 00:00:00