Search results for "neurosurgical procedures"
showing 10 items of 107 documents
Is There an Indication for Intraoperative MRI in Subtotal Resection of Glioblastoma? A Multicenter Retrospective Comparative Analysis.
2017
Objective Surgery in patients with highly eloquent glioblastoma (GB) remains challenging. The aim of this study was to evaluate influence of use of intraoperative magnetic resonance imaging (iMRI) on extent of resection (EOR), clinical outcome, and survival in patients with preoperatively intended subtotal resection of GB. Methods Retrospective assessment was performed in 3 neurosurgical centers (2008–2013). All patients with primary GB, unilocular growth, and adjuvant radiochemotherapy in whom subtotal resection was intended were included. Imaging data were pseudonymized and volumetrically assessed by a central reviewer. Clinical outcome was evaluated based on complications, new permanent …
Arachnoid cysts: How do postsurgical cyst size and seizure outcome correlate?
1998
Arachnoid cysts (ACs) are congenital cystic brain malformations associated with epilepsy. The purpose of this study was to determine the effect of surgical intervention of ACs on cyst size and seizure outcome. We reviewed the world's medical literature dealing with surgically treated ACs in epilepsy patients. Our study included only cases, in which the relationship between pre- and post-operative CT-size of the AC and seizure outcome was described. We also included six patients with ACs and epilepsy treated surgically at the University of Mainz. We analyzed postoperative AC size and seizure outcome with respect to mode of operation, cyst location, and patients' age. A total of 76 patients w…
Noninvasive Hemodynamic Measurements During Neurosurgical Procedures in Sitting Position.
2017
Neurosurgical procedures in sitting position need advanced cardiovascular monitoring. Transesophageal echocardiography (TEE) to measure cardiac output (CO)/cardiac index (CI) and stroke volume (SV), and invasive arterial blood pressure measurements for systolic (ABPsys), diastolic (ABPdiast) and mean arterial pressure (MAP) are established monitoring technologies for these kind of procedures. A noninvasive device for continuous monitoring of blood pressure and CO based on a modified Penaz technique (volume-clamp method) was introduced recently. In the present study the noninvasive blood pressure measurements were compared with invasive arterial blood pressure monitoring, and the noninvasive…
Endoscopic and endoscope-assisted neurosurgical treatment of suprasellar arachnoidal cysts (Mickey Mouse cysts).
2005
Suprasellar arachnoid cysts represent less than 10% of all intracranial arachnoid cysts. Some of them may be quiescent throughout life, some may become symptomatic as they become enlarged and some disappear spontaneously. In this study we discuss the surgical strategies for endoscopic and endoscope-assisted treatment of suprasellar (Mickey Mouse) cysts and analyze the clinical results and experience collected over some years in our department upon doing these operations routinely. Between December 1996 and December 2003, 13 patients (7 female and 6 male patients), mean age 29 years, underwent endoscopic or endoscope-assisted procedures for suprasellar cysts at our department. The indication…
Endoscopy in aneurysm surgery.
2011
BACKGROUND: Surgical clipping with complete occlusion of the aneurysm and preservation of parent, branching, and perforating vessels remains the most definitive treatment for intracranial aneurysms. OBJECTIVE: To evaluate the benefit of endoscopic application during microsurgical procedures in a retrospective study. METHODS: One hundred eighty aneurysms were microsurgically treated in 124 operations. Three different applications of endoscopic visualization were used, depending on the respective requirements: inspection before clipping, clipping under endoscopic view, and postclipping evaluation. RESULTS: Of 1380 aneurysms, 292 procedures were done with application of the endoscope. Of these…
Minimally invasive cerebral cavernoma surgery using keyhole approaches - solutions for technique-related limitations.
2009
Cavernomas are often small in size and located in difficultly accessible regions. Preoperative identification of the ideal surgical approach as well as the precise intraoperative implementation of the surgical plan are of critical importance for successful surgery. While aiming for minimally invasive surgical techniques and maximally effective cavernoma resection, we envisaged that employing a combination of precise and technically sophisticated virtual reality surgery planning, modern navigation systems with augmented reality features and endoscope-assisted surgical techniques should contribute to achieve this goal. Between December 2002 and November 2005, 66 patients were operated on for …
The supracondylar approach to the jugular tubercle and hypoglossal canal.
1998
BACKGROUND Circumscribed lesions of the hypoglossal canal and of the jugular tubercle still remain a surgical challenge. So far, transpetrosal, transcondylar suboccipital, and extreme lateral approaches have been used to access this region. These surgical procedures bear a high risk for neurological deficits. Therefore, we introduce a new minimally invasive extradural approach to the hypoglossal canal that also allows access to the lateral aspects of the jugular tubercle. METHODS After a paramedian retromastoid skin incision, a basal suboccipital craniectomy lateral to the foramen magnum toward the jugular tubercle is performed. With this approach the occipital condyle and the lateral osseo…
Water Jet Dissection in Neurosurgery: An Update After 208 Procedures With Special Reference to Surgical Technique and Complications
2010
Background Water jet dissection represents a promising technique for precise brain tissue dissection with preservation of blood vessels. In the past, the water jet dissector has been used for various pathologies. A detailed report of the surgical technique is lacking. Objective The authors present their results after 208 procedures with a special focus on surgical technique, intraoperative suitability, advantages, and disadvantages. Methods Between March 1997 and April 2009, 208 patients with various intracranial neurosurgical pathologies were operated on with the water jet dissector. Handling of the device and its usefulness and extent of application were assessed. The pressures encountere…
Measurement of Cortical Microcirculation During Intracranial Aneurysm Surgery by Combined Laser-Doppler Flowmetry and Photospectrometry
2011
Accidental vessel occlusion is one major risk of intracranial aneurysm surgery potentially causing cerebral ischemia. The intraoperative assessment of cerebral ischemia remains a technological challenge.As a novel approach, cortical tissue integrity was monitored using simultaneous measurements of regional capillary-venous cerebral blood flow (rvCBF), oxygen saturation (Srvo2), and hemoglobin amount (rvHb) during aneurysm surgery.Fifteen patients scheduled for aneurysm surgery of the anterior and posterior circulation were included. A fiber optic probe was placed on the cortex associated with the distal branch of the aneurysmatic vessel. Blinded measurements by combined laser-Doppler flowme…
Magnetic Resonance Imaging Surveillance for Vestibular Schwannoma After Microsurgical Resection Using a Retrosigmoid Transmeatal Approach.
2020
BACKGROUND Vestibular schwannoma (VS) is a benign, usually slow-growing tumor. The drawback of radical microsurgical VS resection is the increased likelihood of neurologic injury, forcing surgeons to leave a tumor remnant in some cases. We evaluated the prognostic value of magnetic resonance imaging (MRI) enhancement patterns to determine the risk of tumor regrowth. METHODS This clinical study included 30 patients (20 women and 10 men) with VS who underwent surgery via a retrosigmoid transmeatal approach. The extent of resection was assessed by MRI 6 months after surgery. Two subtypes of intracanalicular linear enhancement were defined: linear enhancement of the walls of the internal audito…