ISSN:0268-8697    

DOI:10.3109/02688699108998456

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

The Cosman-Roberts-Wells stereotactic instrument is a recently developed modification, based on an arc-radius design, of the Brown-Roberts-Wells stereotactic frame utilizing the existing fixation and fiducial components of the Brown-Roberts-Wells stereotactic system to localize and verify target data. The design modification has been made with a view to facilitating technical approaches both in stereotactic biopsy and in stereotactic craniotomy, whilst encompassing the same stereotactic space. Initial experience with the Cosman-Roberts-Wells instrument is reported. Over a 5-month period 55 procedures were performed which included 40 stereotactic biopsies, five CT-guided stereotactic craniotomies, three stereotactic placements of a Bennett Ball for thalamotomy, three stereotactic implantations of intracranial electrodes for recording in drug-resistant epilepsy, three aspirations of cyst or haematoma and one implantation of a Gutin catheter for interstitial brachytherapy. There was minimal morbidity and no mortality related to operation. This frame offers rapid targeting without the need to pre-determine entry points, as well as allowing direct lateral passes and unimpeded stereotactic craniotomy.

ISSN:0268-8697    

DOI:10.3109/02688699108998457

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

The records of 53 patients who had undergone transcranial surgery for a non-functioning pituitary adenoma were reviewed. The most common symptom in these patients was visual loss (51 patients). Headache was the presenting symptom in 25 and hypopituitarism in 18. After surgery 17 of the patients were symptom free, 26 were improved, while seven remained unchanged. Three patients died. Other complications occurred in 12 patients but without serious long-term morbidity. Radiation therapy was given to patients in whom subtotal resection of tumour was achieved. None of these patients had tumour recurrence in a mean follow-up period of 76 months, while of the patients in whom tumour extirpation seemed to be complete, 36% had tumour recurrence.

ISSN:0268-8697    

DOI:10.3109/02688699108998458

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

During the 2-year period 1985–86 a total of 1,876 patients were admitted to our hospital after milder head trauma including cerebral concussion. Two hundred and eighty four patients who had a skull X-ray were not selected from guidelines. In 1,592 patients without a skull X-ray, signs of an intracranial complication developed in six cases and were verified by CT. In the 284 patients with skull X-ray a fracture was demonstrated in 25, and of these 25 patients only one patient disclosed a cerebral contusion. In the 259 patients with skull X-ray, but without demonstration of fracture, there were subsequently seen one subdural haematoma and one cerebral contusion. The incidence of intracranial complications in patients without and with skull X-ray with or without fracture does not differ significantly. In these circumstances we do not find any justification for routine skull X-ray after milder head trauma.

ISSN:0268-8697    

DOI:10.3109/02688699108998459

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Pre- and post-operative assessments are presented in 17 adult patients who have been treated with craniovertebral decompression for hindbrain herniation, 11 of whom had syringomyelia. Objective improvement in the size of the syrinx was seen in all 11 cases; contrary to expectation the hindbrain more frequently moved downwards than upwards after decompression of the tonsils and creation of an artificial cisterna magna. A method is reported for the quantitative assessment of hindbrain migration using magnetic resonance imaging (MRI). The degree of‘slump’, further downward displacement of the hindbrain, was compared with the clinical outcome and the MRI appearances. Slump was more common than expected, although the severity was not usually great enough to produce symptoms. Slump was less marked where the artificial cisterna magna was generous (p<0.02). This quantitative method may be useful in assessing patients with unexplained post-operative symptoms and in comparing different surgical techniques.

ISSN:0268-8697    

DOI:10.3109/02688699108998460

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

The case notes of 14 consecutive patients with multiple brain abscesses presenting over a 14 year period were studied with respect to the incidence and presentation, the source of infection, the investigations, microbiology and the treatment and outcome. The incidence of multiple brain abscesses in non-immunocompromised patients is 13% of all intracranial abscesses. Computerized tomographic scanning is vital both in the detection of multiple abscesses and in the subsequent assessment of therapy. The source of infection in half of our patients was the teeth or the paranasal sinuses. Streptococci were isolated in 63% of the patients; staphylococci in 21%. This has obvious implications for the antibiotic policy. Intracranial surgery, with few exceptions, had a diagnostic and management role rather than a curative one; identification of the causative organism was its prime purpose. CSF, obtained by lumbar punctures, did not provide any positive cultures and should not be contemplated in view of the inherent hazards. The elimination of the primary focus of infection was a most important step in the management of this condition. Multiple brain abscesses represent a potentially curable condition, provided appropriate antibiotics are used, the primary septic focus is eliminated and the intracranial complications are anticipated by the use of frequently repeated CT scans.

ISSN:0268-8697    

DOI:10.3109/02688699108998461

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Achieving the required accuracy during such relatively straightforward procedures as tumour biopsy or abscess aspiration remains a challenge especially for the more junior neurosurgeon. A study comparing freehand biopsy with ultrasound-guided biopsy is presented. The use of intraoperative ultrasound increases the accuracy at the expense of a slightly longer operating time. Diagnostic tissue was always obtained using this technique.

ISSN:0268-8697    

DOI:10.3109/02688699108998462

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Intraoperative ultrasound is not a technique which has been widely accepted by neurosurgeons in this country, not least because bulky probes and machines become more of a hindrance than an asset in theatre. The development of new smaller probes, including ones small enough to visualize the brain through a conventional burr-hole has rekindled interest in this subject. Its use for guidance in tumour biopsy, cyst aspiration and catheter placement, as well as volume estimations and determining the completeness of tumour resection, are outlined. The ability to recognize peri-operative haemorrhage is demonstrated.

ISSN:0268-8697    

DOI:10.3109/02688699108998463

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Access to tumours lying in front of the brain stem may be restricted by the neuraxis and cranial nerves, the tentorium, and the bony configuration of the skull base. When there is distortion and attenuation of the brain stem, direct access through the medulla should be considered. A case is described.

ISSN:0268-8697    

DOI:10.3109/02688699108998464

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Intracranial blast injuries in a pheasant found near a bomb crater were reported in 1941 and are reviewed here.

ISSN:0268-8697    

DOI:10.3109/02688699108998465

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor