1,720,999 research outputs found
Different methods for anatomical targeting.
No full textAIM:
Several procedures are used in the different neurosurgical centers in order to perform stereotactic surgery for movement disorders. At the moment no procedure can really be considered superior to the other. We contribute with our experience of targeting method.
METHODS:
Ten patients were selected, in accordance to the guidelines for the treatment of Parkinson disease, and operated by several methods including pallidotomy, bilateral insertion of chronic deep brain electrodes within the internal pallidum and in the subthalamic nucleus (18 procedures). Interventions: in each patient an MR scan was performed the day before surgery. Scans were performed axially parallel to the intercommissural line. The operating day a contrast CT scan was performed under stereotactic conditions. Measures: after digitalization of the MRI images, it was possible to visualize the surgical target and to relate it to parenchimal and vascular anatomic structures readable at the CT examination. The CT scan obtained was confronted with the MR previously performed, the geometrical relation between the different parenchimal and vascular structures and the selected targets were obtained. Stereotactic coordinates were obtained on the CT examination.
RESULTS:
It was possible to calculate the position of the subthalamic nucleus and of the internal pallidum on the CT scan, not only relating to the intercommissural line, but considering also the neurovascular structures displayed both on the MRI and the CT scans.
CONCLUSION:
The technique that our group presents consist in an integration between information derived from the CT and the MR techniques, so that we can benefit from the advantages of both methods and overcome the disadvantages
Telemedicine-assisted treatment of patients with intracerebral hemorrhage
No full textObject. Telemedicine provides a new approach to improve stroke care in community settings, delivering acute
stroke expertise to hospitals in rural areas. Given the controversies in many aspects of the treatment of intracerebral
hemorrhage (ICH) and the lack of guidelines, a prompt neurosurgical second opinion may facilitate the treatment of
patients with ICH. Here, the authors’ 8-year experience with the use of telemedicine in the management of ICH is
reported.
Methods. The medical records of patients with ICH treated through a telemedicine system in the district of
Messina, Italy, between June 2003 and June 2011 were retrospectively reviewed. Neuroradiological and clinical
data for patients were transmitted through a high-technology “hub-and-spoke” telemedicine network. Neurosurgical
teleconsulting (at the hub) was available for 7 peripheral hospitals (spokes) serving about 700,000 people. The authors analyzed 1) the time between peripheral hospital admission and the specialized second opinion consultation, 2)
primary and secondary transfers to the authors’ neurosurgery department, and 3) the treatments (surgical or medical)
of patients transferred to the hub.
Results. The telemedicine network was used to treat more than 2800 patients, 733 with ICH. A neurosurgical
consultation was provided in 38 minutes versus 160 minutes for a consultation without telemedicine. One hundred
seventy-six (24%) of 733 patients were primarily transferred to the hub. Ninety-five patients (13%) underwent surgical treatment. The remaining 81 patients (11%) underwent neurointensive care. Eight (1.4%) of 557 patients treated
at the spokes needed a secondary transfer for surgical treatment because of a worsening clinical condition and/or CT
findings. Considering secondary and inappropriate transfers, the interpretation of data was correct in 96.5% of cases.
Conclusions. Telemedicine allowed rapid visualization of neuroradiological and clinical data, providing neurosurgical expertise to community hospitals on demand and within minutes. It allowed the treatment of patients at
peripheral hospitals and optimized resources. A small percentage of patients treated at the peripheral hospitals had
secondary deterioration. Telemedicine allowed fast patient transfer when necessary and provided improved accuracy
in patient car
Chronic hydrocephalus after subarachnoid hemorrhage: role of lamina terminalis fenestration
No full text
Microsurgical excision of a primary isolated hypothalamic eosinophilic granuloma. Case report.
No full textBrain energy metabolism in the acute stage of experimental subarachnoid haemorrhage: local changes in cerebral glucose metabolism.
No full textLarge sphenocavernous meningiomas: Is there still a role for the intradural approach via the pterional-transsylvian route?
No full textTiming of the examination affects the specificity of 99mTc-MIBI SPECT in distinguishing neoplastic from non-neoplastic brain hematomas
No full textPituitary atypical teratoid rhabdoid tumor in a patient with prolactinoma: A unique description
No full textAtypical teratoid rhabdoid tumor (ATRT) is an aggressive tumor of the CNS and characteristically occurs in the pediatric age. In adulthood, ATRT is rare and it is mainly localized in the cerebral hemispheres. Only 16 cases of ATRT have been described in the sellar region up to now. Interestingly, all sellar ATRTs occurred in adult female patients. Herein we report a novel case of sellar ATRT in a patient with previous history of lactotroph adenoma. Similar to other sellar ATRTs, this case occurred in a female adult patient. At histological examination, it was characterized by a small number of rhabdoid cells. In addition, it did not have homozygous deletion of SMARCB1 gene, but it rather showed a frameshift mutation at exon 4 of SMARCB1 which had not been previously found in ATRT. Clinico-pathological and molecular findings observed in this case confirm previous evidence that sellar ATRT seems to be a distinct entity. Association with previous prolactin-secreting pituitary adenoma is discussed
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