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The results of the surgical and conservative treatment of non neurologic comminuted thoraco-lumbar fractures
No full textSubependymoma of the spinal cord. Case report and review of the literature
No full textSubependymoma is an uncommon, benign and, as a rule, asymptomatic lesion of the central nervous system, only rarely recorded at spinal level. The case reported here brings the total number of spinal subependymomas so far described to 16. The relevant literature is reviewed and the salient fea- tures of these tumors are discussed. Only 15 cases of subependymomoas of the spinal cord have been reported [1, 3-5, 11, 17, 21, 23, 24, 26, 30]. We describe a case of such a tum
Surgical treatment of pial cerebellar arteriovenous fistulas with aneurysm of the main feeder artery
No full textBACKGROUND: Intracranial pial arteriovenous fistulas (pAVFs) are rare vascular lesions only recently considered distinct from arteriovenous malformations. Conservative management was associated with a high mortality rate. The abnormality of the lesion arises from its high-flow nature. The authors present a case of a cerebellar pAVF associated with aneurysms of the main feeding artery that was surgically treated. CASE DESCRIPTION: A 54-year-old woman was referred to us after an attack of severe headache and vomiting. Computerized tomography scan visualized a hematoma of the fourth ventricle. Digital subtraction angiography (DSA) revealed a cerebellar pAVF mainly fed by the right posteroinferior cerebellar artery (PICA) and with drainage into one of the superior cerebellar veins. The PICA presented a saccular aneurysm on its fourth segment and a fusiform dilatation on its third segment. The patient underwent surgical operation via a midline suboccipital craniotomy. The fusiform dilatation was wrapped and the saccular aneurysm was clipped. The most fistulous connections were closed. The draining vein at the level of torcular herophili was closed by application of a clip. Control DSA demonstrated exclusion of both the aneurysms and the fistula from the circulation. At 1-year follow-up, the patient was neurologically intact. CONCLUSIONS: The association of a cerebellar pAVF and an aneurysm is rare. Surgical treatment of multiple-channel arteriovenous fistulas by closure of venous varix should guarantee the exclusion from the circulation and avoid recruitment of new arterial connections and recurrence. Attention must be paid to normal venous channels draining into the varix
Bypass combined with embolization via a venous graft in a patient with giant aneurysm in the posterior comunicanting artery and bilateral idiopathic occlusion of the internal carotid artery in the neck
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Surgical treatment of giant intracranial aneurysms: current viewpoint
No full textAbstract OBJECTIVE: Despite new endovascular techniques and technological advances in microsurgery, the treatment of giant intracranial aneurysms is still a daunting neurosurgical task. Many of these aneurysms have a large, calcified neck, directly involve parent and collateral branches, and are partly thrombosed. In this retrospective review, we focused our analysis on the indications for high-flow, extracranial-intracranial (EC-IC) bypass surgery using a saphenous vein graft. METHODS: A series of 130 patients were treated between 1990 and 2004; 31 patients were managed endovascularly, and 99 patients were treated microsurgically (surgical clipping in 58 patients and high-flow EC-IC bypass followed by aneurysm trapping in 41 patients). We examined the patients' clinical records and pre- and postoperative case notes for cerebral angiographic examinations. Graft patency was verified with cerebral angiography, computed tomographic angiography, Doppler ultrasound, or graft palpation. RESULTS: The high-flow EC-IC bypass was used for all surgically treated prepetrous aneurysms (3 patients), intracavernous aneurysms (1 patient), intracavernous aneurysms with subarachnoid extension (23 patients), as well as for some supraclinoid aneurysms (12 of the 32 patients). It was also used for 1 of the 9 aneurysms located in the carotid bifurcation and 2 of 5 vertebrobasilar circulation aneurysms. Of the 58 patients managed by surgical clipping, 4 (6.9%) died, and 51 (94.4%) improved. Of the 41 patients managed with high-flow EC-IC bypass, 4 (9.8%) died and 34 (91.9%) improved. Graft patency at the follow-up examination was 92.7%. CONCLUSION: The "gold standard" for the treatment of giant aneurysms remains surgical clipping. When direct surgical clipping or endovascular repair is contraindicated, the high-flow EC-IC bypass is a viable surgical optio
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