PubMed Central (PMC3 - NLM DTD)
(2,081,148 recursos)
Archive of life sciences journal literature at the U.S. National Institutes of Health (NIH), developed and managed by NIH's National Center for Biotechnology Information (NCBI) in the National Library of Medicine (NLM).
Mostrando recursos 301 - 320 de 551
301.
Extreme Lateral Approach to Ventral and Ventrolaterally Situated Lesions of the Lower Brainstem and Upper Cervical Cord - Kumar, C.V. Ravi; Satyanarayana, Satish; Rao, B. Ravi Mohan; Palur, Ravikanth S.
Lesions situated ventrally and ventrolaterally to the lower brainstem and upper cervical spinal cord test the skills of neurosurgeons. We present our experience with eight such patients who underwent the extreme lateral craniocervical approach. The pathologies encountered include three distal vertebral aneurysms, one prepontine epidermoid, one anterior foramen magnum meningioma, and three high cervical dumbbell neurofibromas. All lesions were treated effectively. Postoperatively, the patients improved significantly. Complications included transient lower cranial nerve paresis in three patients, meningitis in one patient, and a pseudomeningocele in two patients. All complications improved with therapy. We conclude that the extreme lateral approach offers excellent...
302.
Zygomatic Anterior Subtemporal Approach for Lesions in the Interpeduncular Cistern - Deda, Haluk; Ugur, Hasan Çaglar
The interpeduncular cistern is a difficult region to approach through conventional methods due to its deep location and important adjacent neurovascular structures. Therefore, it is usually difficult to expose the region sufficiently. Technical problems associated with various surgical approaches have led to emergence of combined approaches and their modifications (i.e., the removal of the zygomatic arch). In addition, a frontotemporal craniotomy is reported to provide a wide exposure of the anterior temporal base, thus allowing oblique access to the interpeduncular cistern with minimal brain retraction. This study describes clinicians' experience and the surgical results of 24 patients who underwent a...
303.
Cochlear Schwannomas - Barbieri, Marco; Bruzzo, Michel; Mora, Renato; Meller, Renaud; Chays, André; Magnan, Jacques
In a series of 179 cerebellopontine angle (CPA) tumors, the authors present nine cases (5%) that were cochlear nerve neuromas. There were six men and three women (mean age, 51 years). Preoperative magnetic resonance imaging confirmed the diagnosis in one case with a labyrinthine extension and raised suspicions in the other four cases, which were confirmed during surgery. The remaining neuromas were discovered intraoperatively. The mean time between first observation and surgery was 9 months. Preoperatively, all patients underwent a complete otoneurological assessment. The middle fossa approach was used for the patient with the labyrinthine extension, and the retrosigmoid approach...
304.
Use of the LandmarX Surgical Navigation System in Lateral Skull Base and Temporal Bone Surgery - Staecker, Hinrich; O'Malley, Bert W.; Eisenberg, Howard; Yoder, B. Emmerich
Despite the widespread availability of surgical navigation devices, their use in lateral skull base and temporal bone surgery has been limited. Problems with current systems include difficulty of use and inadequate accuracy. We present a series of cases using the LandmarX surgical navigation system as an adjunct for lateral skull base and temporal bone procedures. This infrared emitting diodes (IRED)-driven system has a post that carries the IREDs and bypasses the need to place the patient in a Mayfield head holder. This configuration allows greater mobility of the surgical field. Registration of the patient can include a combination of fiducial...
305.
Navigation with the StealthStation in Skull Base Surgery: An Otolaryngological Perspective - Heermann, Ralf; Schwab, Burkard; Issing, Peter R.; Haupt, Cornel; Lenarz, Thomas
The introduction of computer-assisted navigation systems has played a significant role in assuring the integration and consistent intraoperative use of radiological information. We used a frameless stereotactic navigation system to treat 62 patients with a variety of skull base pathologies. The optoelectric appliance uses digital imaging information to locate surgical instruments in the operative area. The aim of this study was to evaluate the clinical accuracy, practicality, and impact of this navigation system on otolaryngological procedures. In conjunction with rigid head fixation and bone-anchored registration markers, the precision of registration was 0.8 mm and the accuracy of clinical measurements was...
306.
Extra-Axial Cavernous Hemangioma: Two Case Reports - Kanaan, Imad; Jallu, Ashraf; Alwatban, Jehad; Patay, Zoltan; Hessler, Richard
Two patients with extra-axial cavernous hemangioma who presented with headache and oculovisual disturbances were investigated with computed tomography and magnetic resonance imaging. The lesions masqueraded as basal meningioma, but this diagnosis was not supported by magnetic resonance spectroscopy in one patient. Cerebral angiography with embolization was indicated in one patient, but embolization was not justified in the other. Both patients underwent a pterional craniotomy. The lesions were extradural and highly vascular, necessitating excessive transfusion in one patient in whom gross total resection was achieved, and precluding satisfactory removal in the other. There was no mortality. Transient ophthalmoplegia, the only complication...
307.
Reconstruction of Complicated Skull Base Defects Utilizing Free Tissue Transfer - Djalilian, Hamid R.; Gapany, Markus; Levine, Samuel C.
We managed five patients with large skull base defects complicated by complex infections with microvascular free tissue transfer. The first patient developed an infection, cerebrospinal fluid (CSF) leak, and meningitis after undergoing a translabyrinthine resection of an acoustic neuroma. The second patient had a history of a gunshot wound to the temporal bone, with a large defect and an infected cholesteatoma that caused several episodes of meningitis. The third through the fifth patients had persistent CSF leakage and infection refractory to conventional therapy. In all cases prior attempts of closure with fat grafts or regional flaps had failed. Rectus abdominis...
308.
Dural and Arachnoid Membraneous Protection of the Abducens Nerve at the Petroclival Region - Ozveren, M. Faik; Uchida, Koichi; Tekdemir, Ibrahim; Cobanoglu, Bengu; Akdemir, Ismail; Kawase, Takeshi; Deda, Haluk
The goal of this study was to determine the membranous protection of the abducens nerve in the petroclival region. The petroclival portion of the abducens nerve was studied in ten dissections from five cadaveric head specimens. One of the heads was used for histological sections. Four heads were injected with colored latex for microsurgical dissections. The histological sections were prepared from petroclival dura mater, embedded in paraffin blocks, stained, sectioned in the axial, coronal, and sagittal planes, and evaluated by light microscopy. The abducens nerve was covered by a dural sleeve and arachnoidal membrane during its course within the petroclival...
315.
Facial Nerve Schwannoma of the Cerebellopontine Angle: A Diagnostic Challenge - Lassaletta, Luis; Roda, José María; Frutos, Remedios; Patrón, Mercedes; Gavilán, Javier
Facial nerve schwannomas are rare lesions that may involve any segment of the facial nerve. Because of their rarity and the lack of a consistent clinical and radiological pattern, facial nerve schwannomas located at the cerebellopontine angle (CPA) and internal auditory canal (IAC) represent a diagnostic and therapeutic challenge for clinicians. In this report, a case of a CPA/IAC facial nerve schwannoma is presented. Contemporary diagnosis and management of this rare lesion are analyzed.
317.
Giant Parapharyngeal Space Lipoma: Case Report and Surgical Approach - Smith, Jonathan C.; Snyderman, Carl H.; Kassam, Amin B.; Fukui, Melanie B.
Large parapharyngeal space tumors near critical neurovascular structures pose challenging management problems. Only eight cases of a lipoma in the parapharyngeal space have been reported. We present a surgical approach that permits safe resection of such unusual tumors.
318.
Giant Fusiform Basilar Artery Aneurysm Causing Obstructive Hydrocephalus - Gelal, Fazil; Vidinli, Berna Dirim; Yurt, Alaattin; Cakir, Yusuf; Uygur, Murat
A 58-year-old man presented with a sudden onset gait disturbance and urinary incontinence. Magnetic resonance (MR) imaging and MR angiography showed a fusiform basilar artery aneurysm, 2 cm in diameter and 5 cm long. The aneurysm was thrombosed except the ectatic basilar artery flowing through it. Compression of the cerebrospinal fluid (CSF) pathways caused obstructive hydrocephalus with resultant transependymal CSF leakage. Conventional angiography missed the aneurysm. A one-sided ventriculoperitoneal shunt was placed to treat the patient's hydrocephalus. The patient's symptoms improved after surgery. MR imaging and MR angiography were useful noninvasive methods of detecting the aneurysm, defining its relationship with...
320.
Current Results of the Surgical Management of Acoustic Neuroma - Lee, Sun H.; Willcox, Thomas O.; Buchheit, William A.
A retrospective analysis of 162 consecutive cases in 160 patients who underwent microsurgical resection of vestibular schwannomas between October 1995 and June 2001 was undertaken to compare the results with those of other treatment modalities. Patient hospital records, operative video pictures, neuroimaging studies, audiograms, and follow-up data were reviewed. The mean follow-up period was 24 months.
301.
