Anesthetic management of cerebral aneurysm clipping using the deep hypothermic circulatory arrest technique: a case report.

Deep hypothermic circulatory arrest may prove advantageous during surgery of some technically difficult brain lesions. This technique was first applied in one patient with a large intracavernous aneurysm which had failed standard neurosurgical techniques. For this technique to be successful the cooperation of neurosurgeons, cardiovascular surgeons, anesthesiologists, perfusionists and nurses is essential. Techniques aimed at improving the outcome include a short period of circulatory arrest, the depth of hypothermia, barbiturate administration, coagulation management and well-controlled blood glucose levels. The total time of circulatory arrest and the thiopentone dosage were 61 minutes and 1,700 mg respectively. The lowest core temperature was 13.9 degrees C. The positive outcome supports the use of this technique in selected patients with complex intracranial vascular lesions who may not be operable by standard techniques.

Successful surgical removal of intrinsic medullar vascular malformation: a case presentation.

A 22-year-old man with an intrinsic arteriovenous malformation (AVM) of the medulla, who presented with recurrent subarachnoid hemorrhage and bulbar palsy was described. The successful total surgical removal of this AVM was demonstrated. The clinical, roentgenographic, pathological features and surgical approach of the brainstem vascular malformation were summarized.

Intracranial primitive neuroectodermal tumors: experience of 7 cases with particular reference to survival.

A group of neoplasms consisting of undifferentiated neuroepithelial cells being capable of differentiating into either neuronal or glial line or both directions has been termed "Primitive Neuroectodermal Tumors (PNETs)". They have been shown to possess several similarities in clinical, radiological, and pathological features to the cerebellar medulloblastomas. The latter are well treated by surgical removal followed by radiotherapy. Therefore, we used the same regimen in treating 7 patients with intracranial PNETs and obtained an average survival of 28.7 months which is longer than those of previous reports. The analysis of our patients disclosed an optimistic view that the ideal prognosis of PNETs should be better than this.