Abstract：
:Aneurysms of the vertebro-basilar junction area have been considered the most difficult to be surgically treated because of their deep location, the proximity of the brain stem and the cranial nerves. However, at present, new endovascular techniques and new transbasal surgical approaches offer valuable management strategies. This paper concerns six consecutive patients whom we managed either endovascularly or surgically during a period of eighteen months. Direct surgical treatment was offered to two young patients with relatively small aneurysms in good neurological condition, whereas the other four patients initially underwent an endovascular attempt at aneurysm obliteration using the Guglielmi detachable coil system. Unfortunately, interventional neuroradiology failed in three cases, and surgery had to be re-considered. Accordingly, a total of five patients underwent surgical clipping through the combination of a transmastoid retrolabyrinthine approach with the suboccipital lateral approach. This combination of approaches provided a good control of both vertebral arteries and basilar artery, and allowed the aneurysm to be correctly clipped in all cases. Good long-term results were achieved in all cases but one. Based on this preliminary experience, we would stress the importance of multidisciplinary approach with a treatment calibrated for each single case. Furthermore, if surgery is to be performed, the combination of transmastoid-retrolabyrinthine and suboccipital lateral approaches provides a wide exposure of the whole vertebro-basilar junction area and allows good access to the lesion.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Collice M,Arena O,D'Aliberti G,Todaro C,Branca V,Boccardi E,Versari PP,Bizzozero L,Talamonti Gdoi
10.1007/BF02747192subject
Has Abstractpub_date
1997-01-01 00:00:00pages
124-33issue
2eissn
0001-6268issn
0942-0940journal_volume
139pub_type
杂志文章abstract：INTRODUCTION:Intraoperative detection of residual tumor remains an important challenge in surgery to treat gliomas. New developments in optical techniques offer non-invasive high-resolution imaging that may integrate well into the workflow of neurosurgical operations. Using an intracranial glioma model, we have recentl...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-009-0248-y
更新日期：2009-05-01 00:00:00
abstract：:Early onset "juvenile type" Parkinson's disease is commonly associated with disabling bilateral levodopa-induced dyskinesias. We report here a successful contemporaneous bilateral postero-ventral pallidotomy performed on a 46-year-old male with juvenile type Parkinson's and associated levodopa incited symmetric dyskin...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01808622
更新日期：1994-01-01 00:00:00
abstract：:The introduction of transcranial Doppler ultrasonography (TCD) has made it possible to examine blood flow characteristics in carotid-cavernous sinus fistulae (CCSF) in a noninvasive, relatively simple, and reliable way. This study investigated the usefulness of TCD in the diagnosis and follow-up of various CCSF subtyp...
journal_title：Acta neurochirurgica
pub_type： 临床试验,杂志文章
doi：10.1007/s007010100022
更新日期：2001-12-01 00:00:00
abstract：:Coil migration following cerebral aneurysm treatment has been described and may result in stroke, recurrent aneurysm, or local mass effect. Cerebral coil embolization is also applied in arteriovenous malformations and arteriovenous fistulas, but these pathologies are relatively rare and coil migration is not as well d...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-018-3689-3
更新日期：2018-12-01 00:00:00
abstract：:The authors describe a case of a post-traumatic subdural haematoma with an unusual evolution in two phases, one slow, the other very rapid. The rapidity of the evolution was caused by the rupture of a cortical dural artery, shown angiographically. ...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01401797
更新日期：1979-01-01 00:00:00
abstract：OBJECT:The object of surgical treatment for hemifacial spasm (HFS) is the exclusion of pulsatile neurovascular compression of the root exit zone (REZ). However, spasm persists transiently or permanently in some cases even after complete decompression. In particular, we mainly experience these results when the vertebral...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-011-1247-3
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become an established therapeutic approach for the management of patients with late-stage idiopathic Parkinson's disease (PD). The aim of the present study was to assess regional cerebral blood flow (rCBF) changes related to mot...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-012-1610-z
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:The de novo development of an aneurysm in an previously normal artery is an uncommon event. We describe a patient who developed a de novo bleeding aneurysm of the basilar artery in the three weeks following the surgical removal of a large cerebellar AVM. METHOD-FINDINGS: A 48-year-old man suddenly developed ...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-003-0125-z
更新日期：2003-12-01 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：OBJECTIVE:To prospectively compare the demonstration of the intracranial optic pathway in patients with sellar/juxtasellar tumours and with clinical evidence of visual disturbance using either spoiled gradient recalled acquisition in steady state (SPGR) or conventional spin echo (CSE) T1-weighted imaging. MATERIALS AN...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s007010050138
更新日期：1998-01-01 00:00:00
abstract：:Treatment of vertebral epidural metastases has been in the past and still remains the object of special attention in an attempt to improve the quality of life of these patients. To assess the effects of and indications for surgery, the clinical histories of 53 patients with this malignant disease who had undergone dec...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01407520
更新日期：1990-01-01 00:00:00
abstract：BACKGROUND:Transposition of the vertebral artery (VA) for microvascular decompression for hemifacial spasm (HFS) is often challenging. Various procedures have been proposed to transpose the immobile tortuous VA that cannot be decompressed satisfactorily in the usual manner. METHODS:A Teflon piece that is cut into a we...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-018-03793-1
更新日期：2019-07-01 00:00:00
abstract：:In the arteriovenous malformations of the posterior fossa the arterial feeders and the dural venous sinuses can be identified in anatomical terminology. The arterialised veins which do not conform to adult anatomical descriptions represent the persistent embryonic veins of the metencephalic and myelencephalic segments...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01406021
更新日期：1979-01-01 00:00:00
abstract：:We describe a case of transsphenoidal deflation of a detachable balloon after embolization of a carotid-cavernous fistula (CCF). The patient developed complete third and sixth nerve palsies immediately after detachable balloon embolization of the CCF, which was considered to be caused by cavernous sinus (CS) compressi...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-006-1072-2
更新日期：2007-02-01 00:00:00
abstract：:Regional cerebral blood flow (rCBF) was measured, using the xenon-133 intracarotid injection technique in 10 patients with an acute ischaemic stroke, involving the cerebral cortex, before and after intravenous injection of a single dose of nimodipine (Bay e 9736). After nimodipine application in all patients a dose de...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01728883
更新日期：1982-01-01 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：:Incomplete cerebral ischaemia of 10 to 60 minutes duration was performed by reducing the perfusion pressure of completely isolated canine heads at brain temperatures of 37 and 32 degrees C. Complete cerebral ischaemia of the same duration was performed by complete stopping of the perfusion. The latency of recovery of ...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF02074501
更新日期：1982-01-01 00:00:00
abstract：BACKGROUND:Spinal cord injury (SCI) and the consecutive devastating neurological sequelae have an enormous individual and economic impact. Implantation of functionalized hydrogels is a promising approach, because they can serve as a matrix for the regenerating tissue, carry and release bioactive molecules and various c...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-017-3389-4
更新日期：2018-03-01 00:00:00
abstract：:Migration of the catheter tip of a ventriculoperitoneal shunt (VPS) through a patent processus vaginalis (PV) has seldom being reported. In this series, we analyzed all cases of inguinoscrotal migration of an VPS catheter at our center. Between 1975 and 2015, 295 VPS insertions were performed. In seven infants (2.3%),...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-017-3243-8
更新日期：2017-08-01 00:00:00
abstract：:In our department extensive decompression craniectomies became the treatment of choice for patients with massive cerebral oedema following either trauma or acute cerebral infarction. The remarkable survival rates of this neurosurgical technique created the problem of adequate vault defect reconstruction. To evaluate t...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s007010050335
更新日期：1999-01-01 00:00:00
abstract：:Of 812 patients with intracranial tumours treated by radiosurgery during the period 1984-1990, 129 had meningiomas. Of these latter, 72 had middle fossa meningiomas. Patients with meningiomas treated by us since March 1990 are not included in this report since we established the investigative principle of a minimum of...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01446988
更新日期：1993-01-01 00:00:00
abstract：:Cerebral primitive neuro-ectodermal tumour (PNET) occurring as a second primary malignancy in childhood is exceedingly rare. We present a 7-year-old boy who developed a proven supratentorial PNET five years after enucleation and radio-/chemotherapy for a sporadic, unilateral retinoblastoma with optic nerve invasion. T...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01420048
更新日期：1997-01-01 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：: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
abstract：:During follow-up of 485 adult patients with mainly mild head injury 27% of the patients were unemployed after an observation period of 3-5 years (mean 4.0 years). The length of sick leave during the last 3 years was longer than for a control group. Reduced physical capacity and time of sick leave during the last 3 yea...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01402368
更新日期：1987-01-01 00:00:00
abstract：CLINICAL DETAILS:A 52-year-old man presented with neck pain, nausea and vomiting (Hunt-Hess grade 1). CT scan showed subarachnoid hemorrhage. Cerebral angiography showed multiple arterial aneurysms (right communicating posterior, right anterior choroid, left pericallosal, intraorbital ophthalmic bilaterally). All aneur...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-009-0352-z
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:Mortality and morbidity of aneurysmal subarachnoid haemorrhage (aSAH) remain high, and prognosis is influenced by multiple non-modifiable factors such as aSAH severity. By analysing the chronology of aSAH management, we aim at identifying modifiable factors with emphasis on the occurrence of rebleeds in a se...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-020-04673-3
更新日期：2021-01-06 00:00:00
abstract：:The ventriculographic findings of a severe ascending transtentorial herniation that occurred after shunting in an infant with a posterior fossa tumour are described. ...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01405337
更新日期：1978-01-01 00:00:00
abstract：BACKGROUND:Treatment of complex intracranial aneurysms requires strategic pre-interventional or preoperative planning. In addition to modern three-dimensional (3D) rotational angiography, computed tomography angiography (CTA) or magnetic resonance angiogram (MRA), a solid, tangible 3D model may improve anatomical compr...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-016-2892-3
更新日期：2016-09-01 00:00:00
abstract：:Low-frequency deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) has been reported to improve akinesia and gait difficulties in patients with Parkinson's disease (PD). We report on a patient with PD and L: -dopa refractory gait symptoms who developed detrusor over-activity immediately after right PPN D...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-011-1155-6
更新日期：2011-12-01 00:00:00
