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At least 649 records · Page 36Linked to original sources
PubMed2001

Surgery of lesions in the motor strip combining a stereotactically-guided mini-craniotomy with electrophysiological mapping of the motor cortex.

The removal of space-occupying lesions in the sensori-motor cortex carries a considerable risk of postoperative palsy. Therefore subcortical lesions located in the sensori-motor strip are often considered to be inoperable. Treatment options are stereotactic biopsy and radiosurgery beside radiological control examinations without surgery or surgery with a higher risk of postoperative deficits. The following article focusses on a combined approach involving a stereotactically guided and electrophysiologically controlled surgery. The instruments used (stereotactical system and electric stimulator) are available in almost every neurosurgical department in the Western and Eastern world and had been the first navigation systems in the human brain.

Brain Neoplasms↗
PubMed2005

[Preservation of olfaction in bifrontal craniotomies for lesions of the anterior and middle cranial fossa].

OBJECTIVE: The preservation of the olfactory tract during bifrontal approach for lesions located in the frontal skull base and the supra- and parasellar region has not previously been investigated. METHODS: In our study 12 patients underwent surgery for various lesions via the basal subfrontal route. All patients were observed prospectively, olfaction testing was performed pre- and postoperatively by an independent otorhinolaryngologist. RESULTS: We obtained complete preservation of the olfactory tracts and normal postoperative olfaction in all 12 cases. CONCLUSION: The bifrontal approach allowed a bilateral, wide operative field with excellent orientation and views of important structures. The shortcoming of this method, damage of the olfactory tracts and postoperative anosmia can be overcome.

Adolescent↗
PubMed2006

Using the magnetic resonance three-dimensional volume rendering for tissues technique in the planning of craniotomy flaps with linear scalp incision.

Preoperative three-dimensional images with surface venous anatomy may be used in the planning of a linear scalp incision and the opening site of the dura mater for protection of surface veins during surgical dissection, and to find the splitting site of the brain according to the lesion. In 45 patients who had a brain tumor, linear scalp incision planning was done by regarding the three-dimensional images derived from post-contrast time-of-flight (TOF) sequence raw data. The findings of correspondence and the quality of routine contrast-enhanced magnetic resonance imaging (MRI) and three-dimensional volume rendering for tissues (VRT) images were analyzed separately with the surgical findings according to a visual grading system. Our experience revealed that the surgical findings correlated well with the three-dimensional VRT images. According to a visual surgical grading system, a grade III correlation was found in 20 (45%), grade II in 15 (33%), grade I in 7 (15%), and grade 0 in 3 (7%) patients in our study population. At the end of our research we conclude that this method is useful in terms of the preoperative determination of brain surface anatomy and may be used in the determination of the site of a linear scalp incision according to the localization of an intracranial lesion.

Adult↗
PubMed2002

Hospital-acquired meningitis in patients undergoing craniotomy: incidence, evolution, and risk factors.

OBJECTIVES: To establish the incidence of postcraniotomy meningitis, identify etiologic agents, assess patients' medical progress in relation to both length of hospitalization and mortality, and analyze risk factors. MATERIAL AND METHODS: This study was developed at Hospital São Paulo, a tertiary university hospital, between August 1995 and January 1998. We conducted a case-control trial, in which 50 pairs of patients were matched. RESULTS: An 8.9%-postcraniotomy meningitis incidence was found. Gram-negative bacilli were the most common etiologic agents isolated. Mortality among the patients was 30%. Mean hospital stay for the patients was 42.9 +/- 22.1 days; for the controls, mean hospital stay was 19.0 +/- 11.4 days (P =.00001). Although several risk factors were identified by univariate analysis, including postoperative external ventricular shunt (OR = 2.92, CI 95% = 1.245-6.865, P =.014), remote site infection (OR = 2.85, CI 95% = 0.995-8.173, P =.051), and repeat operation (OR = 5.02, CI 95% = 1.569-16.066, P =.007), only repeat operation remained in the multivariate analysis model (OR = 3.68, CI 95% = 1.158-11.700, P =.027). CONCLUSION: Postcraniotomy meningitis resulted in a high mortality rate and a longer hospital stay, with repeat operation identified among the risk factors.

Brazil↗
PubMed1996

Basal extension of craniotomy for subtemporal middle fossa approach.

Resection of the root of the zygomatic arch including the glenoid fossa, and the roof of the external ear and the superior third of the mastoid process was seen to improve the basal exposure of the lateral subtemporal middle fossa approach. The exposure was horizontally wide. The enhanced exposure helped in reducing the extent of brain retraction that was necessary and improved the working space for manipulation of the instruments.

Craniotomy↗