Surgical Neurology最新文献_第8页

Microsurgical training on an in vitro chicken wing infusion model 体外鸡翅灌注模型的显微外科训练

Surgical Neurology Pub Date : 2009-12-01 DOI: 10.1016/j.surneu.2008.12.008

Jon Olabe MD, Javier Olabe MD, PhD

{"title":"Microsurgical training on an in vitro chicken wing infusion model","authors":"Jon Olabe MD, Javier Olabe MD, PhD","doi":"10.1016/j.surneu.2008.12.008","DOIUrl":"10.1016/j.surneu.2008.12.008","url":null,"abstract":"<div><h3>Background</h3><p>Microneurovascular anastomosis and aneurysm clipping require extensive training before mastering the technique and are a surgical challenge. We developed the “infused chicken wing method” to provide a simple but realistic training method minimizing animal use and need for special facilities for animal care and anesthesia.</p></div><div><h3>Methods</h3><p>Fresh chicken wings were used in this model. The main brachial artery was cannulated, and water was infused at 140 mm Hg followed by anatomical neurovascular dissection. Multiple microsurgical training exercises were performed under microscope vision including terminoterminal, lateroterminal, laterolateral vascular anastomosis, and nerve anastomosis. Different complexity aneurysms were created using venous patches, clipping, rupture, and vascular reconstruction techniques were performed.</p></div><div><h3>Results</h3><p>This novel training model is inexpensive, easily obtainable, and no live animals are required. The diameter and characteristics of arteries and veins used are similar to those of the human brain. Great microsurgical technique progress may be obtained.</p></div><div><h3>Conclusions</h3><p>The infused chicken wing artery model presents a realistic microvascular training method. It is inexpensive and easy to set up. Such simplicity provides the adequate environment for developing microsurgical technique.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 695-699"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2008.12.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28079789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 53

One-stage posterior resection is feasible for a holovertebral aneurysmal bone cyst of the axis: a case report and literature review 一期后路切除治疗椎体全动脉瘤性骨囊肿的可行性:1例报告并文献复习

Surgical Neurology Pub Date : 2009-12-01 DOI: 10.1016/j.wneu.2009.09.007

Li-Yu Fay MD , Jau-Ching Wu MD , Wen-Cheng Huang MD , Yang-Hsin Shih MD , Henrich Cheng MD, PhD

{"title":"One-stage posterior resection is feasible for a holovertebral aneurysmal bone cyst of the axis: a case report and literature review","authors":"Li-Yu Fay MD , Jau-Ching Wu MD , Wen-Cheng Huang MD , Yang-Hsin Shih MD , Henrich Cheng MD, PhD","doi":"10.1016/j.wneu.2009.09.007","DOIUrl":"10.1016/j.wneu.2009.09.007","url":null,"abstract":"<div><h3>Background</h3><p>For cervical spine ABC, staged surgery and the combination of both anterior and posterior approaches are usually necessary for lesions involving all 3 (anterior, middle, and posterior) columns of the spine (holovertebral).</p></div><div><h3>Case Description</h3><p>A 20-year-old young man presented with quadriplegia and acute urine retention lasting for 3 days in November 2006. The diagnosis of an ABC involving the C2 vertebral body, pedicles, laminae, and spinous process was made by MRI. One-stage surgery with intralesional injection of fibrin glue via the posterior approach only was able to deliver complete resection and spinal stabilization. His neurologic function recovered well, and he was able to walk independently 10 days postoperation. At the 1-year follow-up, image studies of the cervical spine demonstrated good bone fusion without recurrence of ABC. The C2 vertebral body also showed resolution of ABC and good trabeculation.</p></div><div><h3>Conclusions</h3><p>Intralesional injection of fibrin glue during the operation for holovertebral ABC can be beneficial to (1) avoid using an anterior approach for complete resection and reconstruction, which was usually required in previous reports, and (2) effectively decrease the blood loss during surgery.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 ","pages":"Pages S80-S85"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.wneu.2009.09.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28534051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Response to Re: Orbitozygomatic approach for excisions of orbital tumors with 1 piece of craniotomy bone flap: 2 case reports by Chi-Wen Chang et al. Surg Neurol 2007; 68 (S1):56-58 [Surg Neurol 2008; 70 (S1):91] Re:眶颧入路1片开颅骨瓣切除眼眶肿瘤2例报告张志文等。神经外科杂志2007;[j]中华神经外科杂志2008;70 (S1): 91)

Surgical Neurology Pub Date : 2009-12-01 DOI: 10.1016/j.wneu.2009.08.001

Hsing-Hong Chen MD

引用次数: 0

Cerebral ischemia due to compression of the brain by ossified and hypertrophied muscle used for encephalomyosynangiosis in childhood moyamoya disease 儿童烟雾病的脑肌瘤合并症中，骨化和肥大的肌肉压迫大脑导致脑缺血

Surgical Neurology Pub Date : 2009-12-01 DOI: 10.1016/j.surneu.2006.10.076

Hajime Touho MD

{"title":"Cerebral ischemia due to compression of the brain by ossified and hypertrophied muscle used for encephalomyosynangiosis in childhood moyamoya disease","authors":"Hajime Touho MD","doi":"10.1016/j.surneu.2006.10.076","DOIUrl":"10.1016/j.surneu.2006.10.076","url":null,"abstract":"<div><h3>Background</h3><p>Encephalomyosynangiosis is one of the indirect method in which ischemic brain surface is covered by temporal muscle for the treatment of moyamoya disease.</p></div><div><h3>Case Descriptions</h3><p>A 14-year-old girl who had been treated with bilateral STA-MCA anastomosis and EMS in 1999 was admitted on January 5, 2005. She showed transient incomplete palsy on the left side of the face and the ipsilateral upper extremity. On the day of admission, MRIs/MRA and 3-dimensional regional CBF measurement using stable xenon and CT scanning were conducted after performance of plain CT scanning. The MRI and CT studies showed that ossified and hypertrophied temporal muscle used for EMS to the right MCA territory compressed the brain just under the muscle. MRA demonstrated well-developed collaterals to the territories of the bilateral MCAs via the previously performed anastomosis. The CBF studies disclosed a low CBF value just under ossified and hypertrophied muscle used for EMS on the right side. She showed same transient ischemic attacks repetitively after January 5, 2005.</p></div><div><h3>Conclusions</h3><p>The repetitive attacks with the transient motor palsy on her left side was thought to be caused by direct compression of the brain by the ossified and hypertrophied muscle used for EMS and decrease in CBF just under it, and its removal was thought to be the treatment of choices. However, the patient and her parents refused the surgical procedure, and she is treated conservatively at present.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 725-727"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2006.10.076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27074000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

神经系统疾病诊断的解剖学基础，C.D. Alberstone, M.P. Steinmetz, I.M. Najm, E.C. Benzel。Thieme出版社，纽约(2007)，504页;$119.95评级:推荐读者:神经病学，神经外科，ISBN: 9780865779761

Surgical Neurology Pub Date : 2009-12-01 DOI: 10.1016/j.surneu.2009.07.048

James I. Ausman MD, PhD ((Editor))

引用次数: 0

Commentary 评论

Surgical Neurology Pub Date : 2009-12-01 DOI: 10.1016/j.surneu.2009.07.005

Jamie S. Ullman MD

引用次数: 0

Commentary 评论

Surgical Neurology Pub Date : 2009-12-01 DOI: 10.1016/j.surneu.2009.05.005

Howard Morgan MD, MA, MS, FACS

引用次数: 0

Alternative option in the treatment of very small ruptured intracranial aneurysms 治疗极小破裂颅内动脉瘤的另一种选择

Surgical Neurology Pub Date : 2009-12-01 DOI: 10.1016/j.wneu.2009.09.003

Ming-Shiang Yang MD , Ho-Fai Wong MD , Tzu-Hsien Yang MD , Yao-Liang Chen MD , Si-Wa Chan MD , Huey-Jen Lee MD , Yung Wei Tung MD , Chung-Wei Tu MD , Tai-Yi Chen MD

{"title":"Alternative option in the treatment of very small ruptured intracranial aneurysms","authors":"Ming-Shiang Yang MD , Ho-Fai Wong MD , Tzu-Hsien Yang MD , Yao-Liang Chen MD , Si-Wa Chan MD , Huey-Jen Lee MD , Yung Wei Tung MD , Chung-Wei Tu MD , Tai-Yi Chen MD","doi":"10.1016/j.wneu.2009.09.003","DOIUrl":"10.1016/j.wneu.2009.09.003","url":null,"abstract":"<div><h3>Background</h3><p>To evaluate the safety and protective effect of relative undersized coil with loose coil core in the clinical dilemma condition—very small (43.0 mm) ruptured intracranial aneurysm.</p></div><div><h3>Methods</h3><p>We studied 12 patients (4 men, 8 women) who had suffered from acute ruptured small intracranial aneurysms (2-3 mm in size, with SAH presentation). All subjects underwent a single coil embolization procedure. An undersized coil (equivalent to the neck size or 0.5 mm smaller than the aneurysm diameter) was chosen as the embolizer.</p><p>Based on the postembolization angiogram, subjects were divided into 2 groups. One was labeled as the initial complete obliteration group (NR) and the other as the incomplete obliteration group (SR). Fisher exact test and the Wilcoxon rank sum test were used to for statistical analysis.</p></div><div><h3>Results</h3><p>The technical success rate was 100% without any procedure-related complication. The follow-up interval ranged from 6 to 32 months. No episode of rebleeding or coil migration could be defined in the admissive and following period. Loose coil core were seen in all patients. The total recurrent rate was 8.3% (1/12); only one patient suffered from recurrent lesion in SR group.</p></div><div><h3>Conclusion</h3><p>The preliminary result showed that under-sized coil packing with loose coil core could provide the protective effect and prevent from further rebleeding for very small ruptured aneurysms. It should be considered as an alternative option in the treatment of acute ruptured very small aneurysms when other conventional strategies are not feasible.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 ","pages":"Pages S41-S46"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.wneu.2009.09.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28534048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Intramedullary spinal cysticercosis cured with medical therapy: case report and review of literature 药物治疗髓内脊髓囊虫病1例报告及文献复习

Surgical Neurology Pub Date : 2009-12-01 DOI: 10.1016/j.surneu.2009.06.011

Sarbjit Singh Chhiber MCh , Bikram Singh MD , Payal Bansal MD , Kamal Kumar Pandita MD , Susheel Razdan DM , Jangbahudar Singh MD

引用次数: 33

Extracranial-intracranial bypass surgery at high magnification using a new high-resolution operating microscope: technical note 使用新型高分辨率手术显微镜进行高倍率的颅外-颅内搭桥手术:技术说明

Surgical Neurology Pub Date : 2009-12-01 DOI: 10.1016/j.surneu.2009.01.030

Nobuhisa Matsumura MD, Takashi Shibata MD, Kimiko Umemura MD, Seiya Nagao MD, Yukio Horie MD

{"title":"Extracranial-intracranial bypass surgery at high magnification using a new high-resolution operating microscope: technical note","authors":"Nobuhisa Matsumura MD, Takashi Shibata MD, Kimiko Umemura MD, Seiya Nagao MD, Yukio Horie MD","doi":"10.1016/j.surneu.2009.01.030","DOIUrl":"10.1016/j.surneu.2009.01.030","url":null,"abstract":"<div><h3>Background</h3><p>We report a precise technique for EC-IC bypass surgery using a stereoscopic high-resolution microscope at magnifications of 40× and 50×.</p></div><div><h3>Methods</h3><p>A stereoscopic operating microscope (Mitaka MM50 Surgical Microscope; Mitaka Kohoki Co, Tokyo, Japan) was used in STA-MCA anastomosis. This microscope has 2 optical systems, a standard zooming system, a newly developed high-magnification system, and 4 fixed working distances of 200, 250, 300 and 350 mm, with highest magnifications of 50.4× at 200 mm and 40.3× at 250 mm. High resolution is achieved by a new lens design in the optical system, which makes the image of the object very clear at high magnification. The magnification can be changed depending on the circumstances in a given procedure. The STA-MCA anastomoses were performed using this microscope.</p></div><div><h3>Results</h3><p>Very small vessels were observable, and arterial anastomosis could be performed precisely at high magnification. All anastomoses were patent on postoperative angiograms.</p></div><div><h3>Conclusions</h3><p>Use of the new microscope allows visualization and manipulation of small vessels at high magnification and high resolution and may be very useful in EC-IC bypass surgery.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 690-694"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.01.030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28438283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7