Search results for "Craniotomy"
showing 10 items of 58 documents
Extradural Endoscopic Dissection of the Anterior Skull Base
1998
A study was conducted from February 29, 1996, to March 28, 1996, at the University of Brno's Pathology Institute in the Czech Republic to explore the possible application of craniofacial intracranial endoscopic techniques through minimal skin incisions and trephines in fresh cadavers (3 to 12 hours old). Through the trephines the dura was totally dissected from the bone. After this dissection a standard bicoronal incision and a full craniotomy was performed to assess the integrity of the meninges. This minimally invasive dissection of the skull base with the aid of an endoscope is characterized by fewer skin incisions, thereby avoiding the exposure of subcutaneous tissue, muscle, cranial bo…
Biportal neuroendoscopic microsurgical approaches to the subarachnoid cisterns. A cadaver study.
1996
A preclinical cadaver study was performed to develop the technique of biportal neuroendoscopic dissection in the subarachnoid space of the basal cisterns and to test the feasibility, utility, and safety of this new technique. In 23 fresh post-mortem adult human cadavers and 2 formalin-fixed adult human head specimen a total of 33 biportal endomicrosurgical dissections into and within the basal cisterns were carried out. Following suction of cerebrospinal fluid from the subarachnoid space 0 degree-, 30 degrees-, and 70 degrees-lens-scopes (Aesculap AG, Tuttlingen, Germany) with outer diameters of 4.2 mm and trochars with outer diameters of 5 to 6.5 mm were introduced into the surgical field.…
Experimental investigations on a model of cryogenic edema.
1987
The role of mechanisms underlying formation and progression of vasogenic brain edema is investigated. On this purpose, cerebral edema was produced by cortical freezing in two different brain situations in rabbits (with or without replacement of bone flap). BBB (Blood-Brain Barrier) breakdown was evaluated by observation of Evans blue extravation, while a histopathological evaluation was carried out by light and transmission electron microscopy. Water content of brain tissue was determined by the wet/dry weight ratio method. Comparison of extension and intensity of cerebral edema between these two groups of animals shows a statistically significant difference: there was evidence of higher wa…
Anaesthetic-related neuroprotection: intravenous or inhalational agents?
2010
In designing the anaesthetic plan for patients undergoing surgery, the choice of anaesthetic agent may often appear irrelevant and the best results obtained by the use of a technique or a drug with which the anaesthesia care provider is familiar. Nevertheless, in those surgical procedures (cardiopulmonary bypass, carotid surgery and cerebral aneurysm surgery) and clinical situations (subarachnoid haemorrhage, stroke, brain trauma and postcardiac arrest resuscitation) where protecting the CNS is a priority, the choice of anaesthetic drug assumes a fundamental role. Treating patients with a neuroprotective agent may be a consideration in improving overall neurological outcome. Therefore, a cl…
Innovations in the Art of Microneurosurgery for Reaching Deep-Seated Cerebral Lesions.
2019
Deep-seated cerebral lesions have fascinated and frustrated countless surgical innovators since the dawn of the microneurosurgical era. To determine the optimal approach, the microneurosurgeon must take into account the characteristics and location of the pathological lesion as well as the operator's range of technical expertise. Increasingly, microneurosurgeons must select between multiple operative corridors that can provide access to the surgical target. Innovative trajectories have emerged for many indications that provide more flexible operative angles and superior exposure but result in longer working distances and more technically demanding maneuvers. In this article, we highlight 4 …
Microsurgical treatment of midfacial tumours involving the skull base
1998
Various approaches to the base of the skull for the treatment of cranial base tumours are described in detail. Advantages and disadvantages of the particular approaches are discussed. This clinical experience is based on 303 neoplasms involving the base of the skull, operated on by the authors. Retrospective survival studies are presented and a review of the literature on the subject is discussed. Utilizing microsurgical techniques the 2-, 3- and 5-year survival rates were significantly improved. The functional and aesthetic outcomes were also dramatically superior compared with standard ablative procedures. Reconstructive postoperative strategies are suggested.
Minimally invasive superficial temporal artery to middle cerebral artery bypass through a minicraniotomy: benefit of three-dimensional virtual realit…
2009
Object The aim of the authors in this study was to introduce a minimally invasive superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery by the preselection of appropriate donor and recipient branches in a 3D virtual reality setting based on 3-T MR angiography data. Methods An STA-MCA anastomosis was performed in each of 5 patients. Before surgery, 3-T MR imaging was performed with 3D magnetization-prepared rapid acquisition gradient echo sequences, and a high-resolution CT 3D dataset was obtained. Image fusion and the construction of a 3D virtual reality model of each patient were completed. Results In the 3D virtual reality setting, the skin surface, skull surface…
Glutamate-containing parenteral nutrition doubles plasma glutamate: A risk factor in neurosurgical patients with blood-brain barrier damage?
1999
OBJECTIVES: Animal studies have shown that the elevation of plasma glutamate levels increase cerebral edema formation whenever the blood-brain barrier is disturbed. Therefore, changes in plasma glutamate levels as influenced by the administration of a glutamate-containing amino acid solution were investigated in neurosurgical patients. DESIGN: Prospective, descriptive study. SETTING: Eight-bed neurosurgical intensive care unit in a university hospital. PATIENTS: Twenty-three neurosurgical patients requiring parenteral nutrition. INTERVENTIONS: Parenteral nutrition was begun 24 hrs after craniotomy. Patients receiving a glutamate-containing amino acid solution (3.75 g/L glutamate) were compa…
Photodynamic therapy within edematous brain tissue: Considerations on sensitizer dose and time point of laser irradiation
1996
Photosensitizer is known to spread with vasogenic edema fluid arising from a cerebral lesion (Neurosurg 33:1075-1082, 1993), which may be essential for sensitizing malignant cells outside the main tumor mass. The present experiments seek to elucidate whether resultant necrosis of perifocal brain tissue after laser irradiation follows a corresponding time pattern and whether damage depends on the photosensitizer dose. Male Wistar rats were anaesthetized with chloralhydrate for venous cannulation, craniotomy and focal cold lesion in order to induce vasogenic edema. Simultaneously, Photofrin II (PF II) was administered at a dose of 5 mg kg-1. The animals were re-anaesthetized after either 4, 1…
Orbital complications of pediatric sinusitis: treatment of periorbital abscess.
1997
Twenty-six children requiring surgical intervention for orbital complications of acute sinusitis were treated at our institutions between 1985 and 1995. Twenty patients were successfully treated surgically utilizing endoscopic/microscopic endonasal surgery, or traditional external ethmoidectomy. However, six patients failed to respond to initial surgical attempts and ultimately required a revision. In one of these six patients the development of an intracranial abscess also necessitated a craniotomy for surgical drainage. Analysis of these six failures was performed with special attention given to the reasons for initial surgical failure and possible means for preventing revision surgeries…