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1.
Acta Neurochir Suppl ; 130: 135-140, 2023.
Article in English | MEDLINE | ID: mdl-37548733

ABSTRACT

Intraoperative ultrasonography is an extremely valuable tool for avoidance of complications during neurosurgical procedures, including resection of intracranial and spinal cord tumors, removal of spontaneous intracerebral hemorrhages and arteriovenous malformations, and ventricular access for shunt placements. Nevertheless, application of this highly useful technique may be accompanied by some challenges and difficulties, as well as human errors; thus, it requires specific knowledge and continuous training.


Subject(s)
Neurosurgery , Humans , Ultrasonography , Neurosurgical Procedures/methods
2.
Br J Neurosurg ; 29(1): 107-109, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25058594

ABSTRACT

Hemifacial spasm is not an infrequent presentation and a vascular loop is commonly implicated. Cerebellopontine angle (CPA) lesions are uncommon but can be excluded with appropriate imaging. There have been only around 150 case reports of CPA lipoma; hemifacial spasm has been associated only in eight cases. We present an additional case and discuss the literature and management.

3.
Neurosurgery ; 62(4): 833-7; discussion 837-8, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18496189

ABSTRACT

OBJECTIVE: We sought to assess the diagnostic yield, complication rates, and therapeutic impact of open brain biopsy and serial stereotactic brain biopsy in the management of patients with nonneoplastic neurological conditions in which conventional investigations did not yield a definitive diagnosis. METHODS: A retrospective case note analysis was undertaken in consecutive patients undergoing brain biopsy at The Walton Centre for Neurology and Neurosurgery during a 15-year period. The diagnostic yield, prebiopsy diagnostic category, biopsy technique (open versus stereotactic), complication rates, and impact on clinical management were assessed. Biopsies were grouped into one of five categories: diagnostic, suggestive, nonspecific, normal, or nondiagnostic. RESULTS: Thirty-nine patients underwent biopsy. The diagnostic yield (combined diagnostic and suggestive) of targeted serial stereotactic biopsy was 64% (seven of 11 patients); in the open brain biopsy group, the diagnostic yield was 46% (13 of 28 patients). The prebiopsy diagnosis was confirmed in 100% (three of three patients) stereotactic biopsy patients and 75% (nine of 12 patients) of open biopsy patients. Two patients (7%) in the open biopsy group had short-term complications. The clinical impact was similar in both groups: nine of 28 (32%) open biopsy patients and four of 11 (36%) stereotactic biopsy patients. CONCLUSION: Despite the low clinical impact, diagnostic brain biopsy should be considered in patients with nonneoplastic undiagnosed neurological disorders. Patients with neuroimaging abnormalities should preferentially undergo targeted biopsy.


Subject(s)
Biopsy, Fine-Needle/methods , Brain Diseases/pathology , Brain Diseases/therapy , Adolescent , Adult , Aged , Brain Neoplasms/pathology , Brain Neoplasms/therapy , Female , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity
4.
Stereotact Funct Neurosurg ; 81(1-4): 50-6, 2003.
Article in English | MEDLINE | ID: mdl-14742964

ABSTRACT

Spinal cord stimulation (SCS) is a treatment modality for medically intractable chronic pain. This study reports an 11-year experience with SCS assessing long-term pain relief and specifically evaluating complications and revisions. It took the form of a retrospective review of medical/surgical records with a postal questionnaire. The subjects were 102 patients with medically intractable chronic pain who underwent SCS implantation between 1989 and 2000. There were 64 revision operations carried out on 35 patients. These comprised electrode replacement/repositioning (29), generator replacement (23), cable failure (3) and implant removal (5). Five (4.9%) implants became infected and 2 required removal. Clinician-reported pain relief was substantial in 69 (68%) patients. This study adds to the weight of evidence that patients undergoing SCS derive significant benefits in terms of pain relief. However, revision rates remain high due to technical and biological factors.


Subject(s)
Electric Stimulation Therapy , Pain Management , Pain/surgery , Spinal Cord/physiology , Spinal Cord/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Chronic Disease , Follow-Up Studies , Humans , Middle Aged , Postoperative Complications , Reoperation , Surveys and Questionnaires , Treatment Outcome
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