0000000000365465
AUTHOR
Michael R. Gaab
Chronic subdural hematoma--craniotomy versus burr hole trepanation.
The authors present a series of more than 200 surgical procedures for chronic subdural hematoma in a 5-year-period. Clinical presentation and neurosurgical treatment were regarded with a special focus on the surgical technique. Between March 2003 and July 2008, 193 patients (113 male and 80 female, mean age 72.5 yrs [range 26–97 yrs]) suffering from chronic subdural hematoma were retrospectively analyzed. One-hundred-fifty-one craniotomies and 42 burr holes were performed. Forty-two craniotomy patients (27.8%) in contrast to 6 burr hole patients (14.3%) required surgical revision. A craniectomy was performed as an ultima ratio after at least 2 prior evacuations in 3 cases. Chronic subdural …
Endoscopic transventricular third ventriculostomy through the lamina terminalis
Object Endoscopic third ventriculostomy (ETV) has become a well-accepted option for obstructive hydrocephalus. However, standard ventriculostomy at the floor of the third ventricle might not be feasible under certain conditions. Here, the authors report in detail on their initial experience with an alternative option of endoscopic ventriculostomy through the lamina terminalis via a transventricular route. Methods Endoscopic third ventriculostomy through the lamina terminalis from a transventricular transforaminal route was evaluated in 4 cadaveric human heads and in 4 clinical cases. Results In all 4 human cadavers, an opening of the lamina terminalis via a transventricular approach could …
Endoscopic Treatment of Intracranial Arachnoid Cysts: A Retrospective Analysis of a 25-Year Experience.
Background Since the development of neuroendoscopy, pure endoscopic fenestration for intracranial arachnoid cysts (ACs) became more and more popular and is actually preferred by many neurosurgeons. Objective To explore their techniques and experiences with endoscopic treatment of intracranial ACs over a 25-yr period. Methods A total of 95 endoscopic procedures in 87 patients with 88 intracranial ACs performed at the authors' departments between February 1993 and October 2018 were retrospectively analyzed. Particular respect was given to surgical technique, complications, patients' outcome, and radiological benefit in relation to cyst location. Results Patients' ages ranged from 23 d to 81 y…
German neuroendoscopy above the skull base
Endoscopy plays an important part in current minimally invasive neurosurgery. The concepts, indications, and standards of current neuroendoscopy were developed in the beginning of the 1990s by several groups of neurosurgeons. Several factors contributed to its success and acceptance, including technical development, influence of other disciplines, and adaptation to neurosurgical requirements. This historical survey focuses on the period when this technique initially emerged, including the scientific discussions of each group as well as the arguments and reasons that led to present intraventricular neuroendoscopy. Interestingly, despite the almost independent development of neuroendoscopic s…
Waterjet Dissection of Peripheral Nerves: An Experimental Study of the Sciatic Nerve of Rats
BACKGROUND: Although waterjet dissection has been well evaluated in intracranial pathologies, little is known of its qualities in peripheral nerve surgery. Theoretically, the precise dissection qualities could support the separation of nerves from adjacent tissues and improve the preservation of nerve integrity in peripheral nerve surgery. OBJECTIVE: To evaluate the potential of the new waterjet dissector in peripheral nerve surgery. METHODS: Waterjet dissection with pressures of 20 to 80 bar was applied on the sciatic nerves of 101 rats. The effect of waterjet dissection on the sciatic nerve was evaluated by clinical tests, neurophysiological examinations, and histopathological studies up …
Endoscopic decompression of the ulnar nerve at the elbow.
OBJECTIVE: Recently, several studies suggested that simple decompression is as effective as anterior transposition in ulnar nerve entrapment syndrome. Simple decompression might be performed with minimally invasive techniques. The authors present their technique and results with endoscopic decompression in ulnar nerve entrapment syndrome. MATERIAL AND METHODS: Between January 2005 and March 2008, 24 patients (mean age, 45.5 years; range, 26-67 years) underwent surgery for 26 ulnar nerve entrapment syndromes (2 bilateral). All patients presented with typical clinical signs and neurophysiologic studies. RESULTS: Intraoperatively, the ulnar nerve was localized directly at the sulcus, and subse…