Central European Neurosurgery最新文献

{"title":"In memoriam. Dr. Hans-Günther Niebeling.","authors":"J Skrzypczak","doi":"10.1055/s-0030-1265208","DOIUrl":"https://doi.org/10.1055/s-0030-1265208","url":null,"abstract":"","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":"72 1","pages":"52"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0030-1265208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29678759","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}

{"title":"Comment to the article: Foramen magnum meningioma: successful surgical resection in a 76-year-old Nigerian.","authors":"Jürgen Meixensberger","doi":"10.1055/s-0031-1273700","DOIUrl":"https://doi.org/10.1055/s-0031-1273700","url":null,"abstract":"Foramen magnum meningiomas are rare and constitute together with upper clival meningioma less than 3 % of all intracranial meningiomas. Usually they originate anterolaterally to the neuroaxis and extend downward to the spinal canal, mostly in women. Such a case was successfully treated by the authors despite the fact the 76-yearold woman was in clinically poor condition and in the absence of advanced technological support. The lesson we can learn from this case can be summarized in the following manner:","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":"72 1","pages":"46"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0031-1273700","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29678758","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}

{"title":"Foramen magnum meningioma: successful surgical resection in a 76-year-old Nigerian.","authors":"A O Adeleye, T B Rabiu","doi":"10.1055/s-0029-1246138","DOIUrl":"https://doi.org/10.1055/s-0029-1246138","url":null,"abstract":"Adeleye AO, Rabiu TB. Foramen Magnum Meningioma: Successful Surgical Resection ... Cen Eur Neurosurg 2011; 72: 44 – 45 Introduction ▼ Foramen magnum meningioma (FMM) is a very rare intracranial lesion [1] . It constitutes such a small percentage (about 2 % ) of brain tumors [2] that even high volume neurosurgical centers in Western countries report series averaging only one case per year [2 – 3] . One explanation for this rarity is the diffi culty in making a clinical diagnosis of FMM, especially before the advent of diagnostic magnetic resonance imaging (MRI) [4 – 6] . The other, more important, reason, however, is the great technical challenge of tumor-ablative surgery in the foramen magnum, a highly limited bony region crowded over by many critical neural-vascular structures of the cervicomedullary junction [7 – 9] . This may actually be the main reason why reports of surgical treatment of FMM are much rarer still from resourcepoor settings. We present one case recently managed successfully in such a practice setting in Nigeria. We are not aware of any other similar report in the accessible literature from Africa.","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":"72 1","pages":"44-5"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1246138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28888679","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}

{"title":"Microsurgically induced pure arterial aneurysm model in rats.","authors":"T Mücke,&nbsp;F Hölzle,&nbsp;K-D Wolff,&nbsp;A Harders,&nbsp;M Scholz","doi":"10.1055/s-0030-1249699","DOIUrl":"https://doi.org/10.1055/s-0030-1249699","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to develop a reliable and reproducible arterial aneurysm model for microsurgical training and further research with dimensions comparable to those encountered in aneurysms in humans.</p><p><strong>Methods: </strong>The arterial aneurysm models were created microsurgically at the bifurcation of the abdominal aorta using a graft of the carotid artery in 20 Wistar rats.</p><p><strong>Results: </strong>The aneurysms were created successfully and no complications occurred. The average volume of this arterial aneurysm model was 35.19±5.64 mm (3). The time required to create this kind of aneurysm was 192±14.4 min. The central zone of blood inflow into the aneurysm was not affected by any thrombus formation.</p><p><strong>Conclusion: </strong>The presented model at the aortic bifurcation in the rat is reliable and immediately available for microsurgical and technical training as well as for scientific studies on aneurysms. Since this kind of model also reproduces arterial aneurysms, basic techniques such as suturing and microtechniques needed for the dissection and repair of vessels can be taught during its creation.</p>","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":"72 1","pages":"38-41"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0030-1249699","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29532734","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}

{"title":"A short review of game theory for neurosurgeons.","authors":"H-J Steiger,&nbsp;U R Steiger","doi":"10.1055/s-0029-1246132","DOIUrl":"https://doi.org/10.1055/s-0029-1246132","url":null,"abstract":"<p><p>Neurosurgery and medicine in general are increasingly dominated by economic factors and considerations. Physicians themselves have partially adopted economic terminology, although they rarely have a profound knowledge of economics. Today game theory is one of the most important factors driving microeconomics, which is the competition for limited resources within a small group of individuals. The purpose of this article is to give a short introduction to game theory and its application to the healthcare system. The Prisoner's Dilemma considers strategies between two persons. In the classic version two burglars are caught. Each could confess and be released from jail if the other does not confess--who will then get a long term in prison. If both confess, both get an intermediate time in jail, and if no one confesses, both get a mild sentence. Wanting to be released from jail, they both confess and get the intermediate term in prison. This remarkable result, initially described by John von Neumann in 1928 and showing that individually rational actions can result in both persons becoming worse off, had a great impact on modern social science. Other scenarios are more complex. The Nash Equilibrium is a wider concept. If there is a set of strategies with the property that no player can benefit by changing his strategy while the other players keep their strategies unchanged, then that set of strategies and the corresponding payoffs constitute the Nash Equilibrium. Another concept particularly important in sociology is the Pareto criterion. If no one can be made better off without making somebody else worse off, then that outcome is Pareto optimal. Respecting these basic principles is a necessary precondition for successful deals and cooperative projects.</p>","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":"72 1","pages":"28-31"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1246132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28995651","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}

{"title":"Outcome of craniocerebral gunshot injuries in the civilian population. Prognostic factors and treatment options.","authors":"A K Petridis,&nbsp;A Doukas,&nbsp;H Barth,&nbsp;M Mehdorn","doi":"10.1055/s-0029-1241850","DOIUrl":"https://doi.org/10.1055/s-0029-1241850","url":null,"abstract":"<p><strong>Aim: </strong>Gunshot wounds to the head are rare in Europe. They may be inflicted by low-velocity handguns, captive bolt guns and tear gas cartridges and mostly result from suicide attempts. The experience of neurosurgeons with this kind of traumatic injury is decreasing; the aim of this study was therefore to analyse prognostic factors which help to decide whether or not to operate and to discuss treatment options.</p><p><strong>Methods: </strong>Thirty patients with gunshot head injuries treated in our hospital from 1993 to 2008 were retrospectively evaluated. Glasgow Coma Scale (GCS) score, pupil reactivity, lesion localisation, number of bone fragments, intracranial pressure (ICP), midline shift, hypotension, and dural penetration were analysed for their prognostic value. Surgically and non-surgically treated patients were evaluated separately. Complications were registered.</p><p><strong>Results: </strong>A low GCS of 3-8, fixed pupils, >2 bone fragments, bilobar or posterior fossa/brainstem lesions and ICP >45 mmHg were indicators of a poor prognosis.</p><p><strong>Conclusion: </strong>Patients with a GCS of 3-8 and two non-reactive pupils should not be operated. If one or both of the pupils are reactive, surgery should be performed irrespective of the GCS score, except in patients with translobar/transventricular wounds. Even if there are no clear contraindications to surgery, the outcome is expected to be poor in patients with a low GCS score, midline shift >10 mm, >2 bone fragments in the brain, and a bilobar, posterior fossa/brainstem or ventricular lesion and ICP >45 mmHg. When surgery is performed the wound and the missile or bone track should be debrided meticulously, the wound and dura should be closed in a watertight fashion and antibiotic prophylaxis as well as tetanus serum should be given.</p>","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":"72 1","pages":"5-14"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1241850","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28862050","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}

{"title":"Does electrode placement influence quality of intraoperative monitoring in vestibular schwannoma surgery?","authors":"S Rampp,&nbsp;J Prell,&nbsp;J C Rachinger,&nbsp;C Scheller,&nbsp;C Strauss","doi":"10.1055/s-0030-1253350","DOIUrl":"https://doi.org/10.1055/s-0030-1253350","url":null,"abstract":"<p><strong>Object: </strong>Continuous recording of electromyographic signals (EMG) is a standard method for intraoperative monitoring of facial nerve function in cerebello-pontine angle surgery. Subcutaneous needle electrodes in the facial muscles are used in different setups. The goal of this study was to compare two commonly used electrode setups concering sensitivity for pathological EMG activity.</p><p><strong>Patients and methods: </strong>A group of 10 patients undergoing vestibular schwannoma surgery were examined. Continuous EMG from facial muscles was recorded using needle electrodes in setups according to Kartush or Møller, with narrow or wide interelectrode distances, respectively. Quantity of pathological A-train activity and signal-to-noise ratios were compared between setups.</p><p><strong>Results: </strong>A-train activity was seen in all patients. On average, 37% of A-train activity was seen in the Kartush setup alone, 4% in Møller setups alone and 59% in both setups synchronously (p<0.05; ratio of median train time--Kartush:Møller 3:2). The wide interelectrode distance of the Møller setup was found to be significantly more susceptible to artefacts, especially to low frequency and power line noise. Artefacts were the main reason for the Møller setup to fail detecting A-train activity.</p><p><strong>Conclusions: </strong>For continuous intraoperative monitoring of facial nerve function, narrow interelectrode distance should be used.</p>","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":"72 1","pages":"22-7"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0030-1253350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29051643","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}

{"title":"Implementation of a critical incident reporting system in a neurosurgical department.","authors":"P Kantelhardt,&nbsp;M Müller,&nbsp;A Giese,&nbsp;V Rohde,&nbsp;S R Kantelhardt","doi":"10.1055/s-0029-1243199","DOIUrl":"https://doi.org/10.1055/s-0029-1243199","url":null,"abstract":"<p><strong>Background: </strong>Critical incident monitoring is an important tool for quality improvement and the maintenance of high safety standards. It was developed for aviation safety and is now widely accepted as a useful tool to reduce medical care-related morbidity and mortality. Despite this widespread acceptance, the literature has no reports on any neurosurgical applications of critical incident monitoring. We describe the introduction of a mono-institutional critical incident reporting system in a neurosurgical department. Furthermore, we have developed a formula to assess possible counterstrategies.</p><p><strong>Methods: </strong>All staff members of a neurosurgical department were advised to report critical incidents. The anonymous reporting form contained a box for the description of the incident, several multiple-choice questions on specific risk factors, place and reason for occurrence of the incident, severity of the consequences and suggested counterstrategies. The incident data was entered into an online documentation system (ADKA DokuPik) and evaluated by an external specialist. For data analysis we applied a modified assessment scheme initially designed for flight safety.</p><p><strong>Results: </strong>Data collection was started in September 2008. The average number of reported incidents was 18 per month (currently 216 in total). Most incidents occurred on the neurosurgical ward (64%). Human error was involved in 86% of the reported incidents. The largest group of incidents consisted of medication-related problems. Accordingly, counterstrategies were developed, resulting in a decrease in the relative number of reported medication-related incidents from 42% (March 09) to 30% (September 09).</p><p><strong>Conclusions: </strong>Implementation of the critical incident reporting system presented no technical problems. The reporting rate was high compared to that reported in the current literature. The formulation, evaluation and introduction of specific counterstrategies to guard against selected groups of incidents may improve patient safety in neurosurgical departments.</p>","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":"72 1","pages":"15-21"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1243199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28606151","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}

{"title":"Brainstem glioma in PHACES syndrome: case report and review of the literature.","authors":"J Mohebali,&nbsp;M T Walsh,&nbsp;W T Couldwell","doi":"10.1055/s-0029-1242757","DOIUrl":"https://doi.org/10.1055/s-0029-1242757","url":null,"abstract":"Examination The fi ndings at physical examination were remarkable for a large 5 × 4 cm hemangioma that extended from the patient ’ s hairline down to the right forehead. A fundoscopic examination demonstrated pallor of the right optic nerve. Cranial nerve testing revealed decreased abduction of the left eye as well as endgaze nystagmus. Additionally, subtle left upper facial weakness was present. The results of cerebellar testing were normal. The patient ’ s speech revealed dysarthria. The remaining neurological and physical examinations were unremarkable.","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":"72 1","pages":"46-8"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1242757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28928280","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}

{"title":"Epidemiology of pediatric brain tumors in Greece (1991-2008). Experience from the Agia Sofia Children's Hospital.","authors":"G A Alexiou,&nbsp;M Moschovi,&nbsp;K Stefanaki,&nbsp;G Sfakianos,&nbsp;N Prodromou","doi":"10.1055/s-0030-1268495","DOIUrl":"https://doi.org/10.1055/s-0030-1268495","url":null,"abstract":"<p><strong>Background: </strong>We set out to determine the epidemiology of pediatric brain tumors in a single Greek institute.</p><p><strong>Methods: </strong>We reviewed all cases of brain tumors in children, under the age of 15 years, that were treated surgically in the Neurosurgical Department of Children's Hospital \"Agia Sofia\", between January 1991 and December 2008.</p><p><strong>Results: </strong>From January 1991 through December 2008, we encountered 335 cases of pediatric brain tumors. The mean age was 7.2 years and there was a slight male predominance. Astrocytomas made up the largest component, with pilocytic astrocytomas accounting for 25.6% of all tumors. The second most common entity was medulloblastoma, accounting for 18% of all tumors, whereas ependymomas were the third most frequent tumor. There was an increase in the total number of brain tumors during the last decade. Furthermore, examining low-grade astrocytoma, medulloblastoma and ependymoma trends over the last 2 decades, we found a trend for a decrease of low-grade astrocytomas and an increase of the more aggressive medulloblastomas and ependymomas.</p><p><strong>Conclusion: </strong>This study presents the first epidemiological data of pediatric brain tumors in Greece. Astrocytomas were the most common tumor followed by medulloblastomas and ependymomas. Furthermore, a trend for an increase of malignant tumors over the last decade has been observed.</p>","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":"72 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0030-1268495","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29678757","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}