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Gamma knife radiosurgery for basal cell carcinoma of the eyelid: report of a case
We report here a case of BCC in the eyelid of a patient who was successfully treated by gamma knife radiosurgery (GKRS). He was 88  years old at this time. The ulcer disappeared within 3 weeks after GKRS and was covered with normal epithelium. This is the first report to describe an eyelid BCC that was treated by GKRS. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2018 Category: Neurosurgery Source Type: research

Manipulating an internal pulse generator until twiddler ’s syndrome in a patient treated with deep brain stimulation for obsessive-compulsive disorder
Conclusion: The patient did not have com pulsions related to touching objects at admission, thus making it difficult to foresee and prevent TS. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2018 Category: Neurosurgery Source Type: research

Regional Hounsfield unit measurement of screw trajectory for predicting pedicle screw fixation using cortical bone trajectory: a retrospective cohort study
AbstractBackgroundThe sufficiency of screw anchoring is a critical factor for achieving successful spinal fusion; however, no reliable method for predicting pedicle screw fixation has been established. Recently, Hounsfield units (HU) obtained from computed tomography (CT) was developed as a new reliable tool to determine the bone quality. The purpose of the present study was to demonstrate the utility of regional HU measurement of the screw trajectory to predict the primary and long-term fixation strength of pedicle screws.MethodThe insertional torque of pedicle screws using the cortical bone trajectory technique was measu...
Source: Acta Neurochirurgica - January 12, 2018 Category: Neurosurgery Source Type: research

Brain pulsations enlightened
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2018 Category: Neurosurgery Source Type: research

Investigation of the usefulness of fluorescein sodium fluorescence in stereotactic brain biopsy
ConclusionsFluorescein sodium fluorescence is as accurate as frozen section assessment in confirming sampling of pathological tissue in the stereotactic biopsy of gadolinium-contrast-enhancing brain lesions. Fluorescein sodium fluorescence-guided stereotactic biopsy is a useful addition to the neurosurgical armamentarium. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2018 Category: Neurosurgery Source Type: research

Transcondylar approach for resection of lateral medullary cavernous malformation
ConclusionsDespite conservative handling of the occipital condyle, craniocervical stability may vary in patients after transcondylar surgery. A “dynamic” computer tomography, with views of the atlanto-occipital joint at each end-rotational extreme, may be the best postoperative assessment tool to evaluate the stability of the craniocervical junction. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2018 Category: Neurosurgery Source Type: research

Traumatic vertebral artery rupture causing intraspinal hematoma and progressive neurological symptoms
AbstractTraumatic vertebral artery rupture is extremely rare. Herein, we report a case of traumatic vertebral artery rupture causing extensive intraspinal hematoma and progressive neurological symptoms. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2018 Category: Neurosurgery Source Type: research

Flexible endoscopically assisted evacuation of acute and subacute subdural hematoma through a small craniotomy: preliminary results
ConclusionsThe results reported here suggest that small craniotomy evacuation with a flexible endoscope is a safe, effective, and minimally invasive treatment for acute and subacute SDH in selected cases. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2018 Category: Neurosurgery Source Type: research

ICP curve morphology and intracranial flow-volume changes: a simultaneous ICP and cine phase contrast MRI study in humans
ConclusionThe first part, or the P1, of the ICP curve seems to be created by the first rapid net inflow seen in Flowtot while the rest of the ICP curve seem to correlate to the ΔICV. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2018 Category: Neurosurgery Source Type: research

Correction to: Vasomodulatory effects of the angiotensin II type 1 receptor antagonist losartan on experimentally induced cerebral vasospasm after subarachnoid haemorrhage
AbstractThe original version of this paper unfortunately captured the names of Florian Gessler and Volker Seifert incorrectly and are now corrected in this paper. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2018 Category: Neurosurgery Source Type: research

Kim J. Burchiel: Handbook of pain surgery
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 11, 2018 Category: Neurosurgery Source Type: research

Quality of life and disability 12 months after surgery vs. conservative management for unruptured brain arteriovenous malformations: Scottish population-based and Australian hospital-based studies
ConclusionsWe did not find a statistically significant difference between surgery  ± preoperative embolisation and conservative management in disability or QOL at 12 months. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 11, 2018 Category: Neurosurgery Source Type: research

Long-term control and predictors of seizures in intracranial meningioma surgery: a population-based study
ConclusionSeizures are common before and after intracranial meningioma surgery. Approximately one third of patients with preoperative seizures become seizure-free on long-term follow-up after surgery, while 14% experienced new-onset seizures after surgery. Larger tumor size, absence of headache, and non-skull base location were associated with preoperative seizures, while tumor size and preoperative seizures were associated with postoperative seizures. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 11, 2018 Category: Neurosurgery Source Type: research

Association of decision-making in spinal surgery with specialty and emotional involvement —the Indications in Spinal Surgery (INDIANA) survey
AbstractBackgroundAlthough recent trials provided level I evidence for the most common degenerative lumbar spinal disorders, treatment still varies widely. Thus, the Indications in Spinal Surgery (INDIANA) survey explores whether decision-making is influenced by specialty or personal emotional involvement of the treating specialist.MethodNationwide, neurosurgeons and orthopedic surgeons specialized in spine surgery were asked to answer an Internet-based questionnaire with typical clinical patient cases of lumbar disc herniation (DH), lumbar spinal stenosis (SS), and lumbar degenerative spondylolisthesis (SL). The surgeons ...
Source: Acta Neurochirurgica - January 10, 2018 Category: Neurosurgery Source Type: research

Intraoperative tools for cerebral bypass surgery
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 10, 2018 Category: Neurosurgery Source Type: research

Burr hole trepanation for chronic subdural hematomas: is surgical education safe?
ConclusionsBurr hole trepanation for cSDH can be safely performed by supervised neurosurgical residents enrolled in a structured training program, without increasing the risk for revision surgery, perioperative complications, or worse outcome. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 8, 2018 Category: Neurosurgery Source Type: research

Predictors of ventricular tension pneumocephalus after posterior fossa surgery in the sitting position
ConclusionsEntrapment of intracranial and particularly ventricular air requiring emergent EVD occurred in 3.9% cases of intracranial surgery in the sitting position. Especially the opening of the fourth ventricle was associated with the development of VTP, which should warrant particularly diligent postoperative observation of these patients. In cases without neurological symptoms, the rate of spontaneous air resorption is sufficiently high to warrant expectant management. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2018 Category: Neurosurgery Source Type: research

Successful microsurgical treatment of intracranial aneurysms in infants: a retrospective study and literature review
ConclusionIntracranial aneurysms should be considered in the differential diagnosis of infants who present with acute raised intracranial pressure. An improvement of neurological deficits is noted in infants who are managed promptly with microsurgical techniques of clipping during the long-term follow-up. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2018 Category: Neurosurgery Source Type: research

Fluorescein videoangiography during extracranial-to-intracranial bypass surgery: preliminary results
ConclusionsFluorescein videoangiography is a cost-effective, easy-to-use, fast and safe intraoperative tool and is useful to assess graft patency and extent of cortical vascular network also in deeper cortical areas. In case of deep-seated anastomosis, it provides the great advantage of performing real-time manipulation of neurovascular structures during videoangiography observation. It could represent a valuable complementary or alternative technique to assess intraoperative bypass function. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2018 Category: Neurosurgery Source Type: research

Cerebellar infarction after posterior direct reduction and fixation to treat an unstable Jefferson fracture: a case report
AbstractA 42-year-old man had an unstable Jefferson type IV atlas fracture with unilateral vertebral artery occlusion after a diving accident. We performed C1-ring reconstruction with a crosslink rod and C2 fixation to directly reduce the fracture fissure. Within 6  h, cerebellar hemisphere infarction developed. After decompressive craniectomy, duroplasty, and release of the vertebral artery occlusion caused by the transfixing rod, a postoperative computed tomography angiogram showed that blood flow in the right vertebral artery improved. We suggest cautiousl y inserting screws into the fractured C1 lateral mass and g...
Source: Acta Neurochirurgica - January 6, 2018 Category: Neurosurgery Source Type: research

Gross total resection of pituitary adenomas after endoscopic vs. microscopic transsphenoidal surgery: a meta-analysis
AbstractBackgroundMicroscopic transsphenoidal surgery (mTSS) is a well-established method to address adenomas of the pituitary gland. Endoscopic transsphenoidal surgery (eTSS) has become a viable alternative, however. Advocates suggest that the greater illumination, panoramic visualization, and angled endoscopic views afforded by eTSS may allow for higher rates of gross total tumor resection (GTR). The aim of this meta-analysis was to determine the rate of GTR using mTSS and eTSS.MethodsA meta-analysis of the literature was conducted using PubMed, EMBASE, and Cochrane databases through July 2017 in accordance with PRISMA g...
Source: Acta Neurochirurgica - January 6, 2018 Category: Neurosurgery Source Type: research

Mariano Socolovsky, Lukas Rasulic, Rajiv Midha, and Debora Garozzo (eds): Manual of peripheral nerve surgery: from the basics to complex procedures
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2018 Category: Neurosurgery Source Type: research

Image-guided Ommaya reservoir insertion for intraventricular chemotherapy: a retrospective series
ConclusionsWe demonstrate improved accuracy and decreased complications using an image-guided approach compared with a traditional approach. Our results support routine use of intra-operative image guidance for proximal catheter insertion in elective ORI for intraventricular chemotherapy. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 5, 2018 Category: Neurosurgery Source Type: research

Heat generation by ultrasonic bone curette comparing with high-speed drill
This study quantitatively assessed the heat generated by an ultrasonic bone curette and compared it to that by a high-speed drill.MethodsThe thermal change in a swine skull during bone curetting using an ultrasonic device and a high-speed drill were assessed. The investigation focused on the type of surgical manipulation (brush-like strokes vs. pushing motion) and irrigation (room temperature vs. cold water; low-volume irrigation vs. high-volume irrigation).ResultsThe thermal elevation during drill use was suppressed when using brush-like strokes compared to pushing motion (brush-like strokes, 44.7  °C; pushing mo...
Source: Acta Neurochirurgica - January 4, 2018 Category: Neurosurgery Source Type: research

Compression of a giant pseudomeningocele causing transient anoxic seizures —a case report
AbstractTransient anoxic seizure upon application of pressure on a giant pseudomeningocele has never been reported in the literature; such abrupt changes in intracranial pressure due to large volume of cerebrospinal fluid (CSF) translocation, if left untreated may lead to permanent cerebral hypoxic injury and death. Here we describe a case of a 26-year-old woman who had undergone lumbar disc surgery in another unit few months ago and developed a large lump around her back. Any pressure on the lump resulted in headaches and at times episodes of seizures. Clinical examination revealed a very large fluid-filled lump consisten...
Source: Acta Neurochirurgica - January 3, 2018 Category: Neurosurgery Source Type: research

Letter to the editor of Acta Neurochirurgica: simultaneous pericranial and nasoseptal “double-flap” reconstruction after combined transcranial and endoscopic endonasal resection of anterior skull base tumors
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

The tethered effect of the arachnoid in vago-glossopharyngeal neuralgia: a real associated alternative mechanism?
We report two cases of VGPN caused by tethered arachnoid, associated with a vascular contact in which pain was reduced by freeing rootlets from arachnoid compression. We report two cases relating to 50-year-old and 30-year-old men with a history of electric shooting pain triggered by swallowing in the right pharyngeal and auricular regions. Preoperative MRI documented a neurovascular conflict in the first case and an arachnoid cyst in the second. Surgery was performed via a retrosigmoid craniotomy. In both cases, the intraoperative findings documented a tethered arachnoid membrane compressive to cranial nerves IX and X. Un...
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

BioGlue ® induced granuloma causing symptomatic spinal cord compression: a late complication
AbstractBioGlue ® is an inert, bioadhesive surgical substance commonly used in spinal surgery to aid dural closure. The authors describe two cases in which the use of BioGlue® caused a local reaction culminating in the formation of a granuloma that caused cord compression several years after surgery in one case i n which a second operation was required to relieve cord compression and remove the foreign material. In the other case spontaneous resolution occurred. To our knowledge these are the first reports of delayed spinal cord compression secondary to BioGlue®-induced granuloma. We recommend judicious use of ...
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

How I do it: endoscopic microvascular decompression for hemifacial spasm associated with the vertebral artery
ConclusionEndoscopic MVD offers reliable decompression for VA-associated HFS with minimal invasiveness. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

Intraoperative monitoring of sensory part of the trigeminal nerve using blink reflex during microvascular decompression for trigeminal neuralgia
We describe the case of a patient who developed hemifacial hypoesthesia after microvascular decompression surgery for trigeminal neuralgia. Intraoperative BR showed a severe loss of R1 amplitude. BR might be a useful intraoperative technique to monitor the sensory part of the trigeminal nerve. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

Surgical ligation of spinal dural arteriovenous fistula
ConclusionsLaminectomy and arteriovenous fistula ligation is a safe and reliable approach for accessing and treating spinal dural arteriovenous fistulas. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

Relation of gray-white matter ratio with long-term cognitive functions and quality of life in patients with mild to moderate aneurysmal subarachnoid hemorrhage: a prospective observational study
AbstractBackgroundIn the present study, we hypothesized that a low gray matter-white matter ratio (GWR) is associated with poor cognitive function and low quality of life in patients with mild to moderate (WFNS ≤3) aneurysmal subarachnoid hemorrhage (aSAH).MethodsAll patients with aSAH who were admitted to the neurointensive care unit (Neuro ICU) and whose WFNS score was  ≤ 3 were enrolled in the study. During the Neuro ICU follow-up period, the following variables were recorded: demographics, neurological status, comorbidities, time elapsed between onset of bleeding and Neuro ICU admission, treatment metho...
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

Vertebrobasilar dolichoectasia causing homonymous hemianopia: a case report and review of the literature
AbstractA 73-year-old man was diagnosed with an incidental finding of right homonymous hemianopia and presyncopal spells. Magnetic resonance imaging revealed a vertebrobasilar dolichoectasia (VBD) with compression of the left optic tract. VBD is defined as an elongation and dilatation of the basilar artery. Only a few cases have been described in the literature of VBD causing optic tract compression. So far no treatment option has been described for these cases, while surgical options exist for compressions of other cranial nerves, most commonly the trigeminal nerve. VBD can further cause stroke or cerebral and subarachnoi...
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

Quantitative study of the correlation between cerebellar retraction factors and hearing loss following microvascular decompression for hemifacial spasm
AbstractBackgroundThis prospective study quantitatively measured the cerebellar retraction factors, including retraction distance, depth and duration, and evaluated their potential relationship to the development of hearing loss after microvascular decompression (MVD) for hemifacial spasm (HFS).MethodsOne hundred ten patients with primary HFS who underwent MVD in our department were included into this study. The cerebellar retraction factors were quantitatively measured on preoperative MR and timed during MVD. Associations of cerebellar retraction and other factors to postoperative hearing loss were analyzed.ResultsEleven ...
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

Decompressive craniectomy, ICP monitoring and secondary necrosectomy as treatment options in patients presenting with malignant ischemic infarctions extending beyond the middle cerebral artery territory
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

Long-term follow-up of multimodality treatment for multiple sclerosis-related trigeminal neuralgia
ConclusionsThe majority of MS-TN patients become medically refractory and require multiple repeat surgical procedures. MS-TN procedures were associated with high rates of pain recurrence and our data suggests reoperation within 1  year is often necessary. Optimal management strategy in this patient population remains to be determined. Patients need to be counseled on managing expectations as treatments commonly afford only temporary relief. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

The learning curve for endoscopic trans-sphenoidal resection of pituitary macroadenomas. A single institution experience, Leeds, UK
ConclusionsThis study demonstrates that in our institution there is no statistically significant learning curve for the endoscopic resection of pituitary macroadenoma. However, there is a trend of improvement in tumor resection with experience for one surgeon. These findings suggest that the surgeons in our institution were capable of performing this procedure effectively with a low complication rate since adoption of the endoscopic technique in 2009. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

Early recognition of aggressive pituitary adenomas: a single-centre experience
ConclusionsWe proposed a new and comprehensive definition of aggressive pituitary adenoma, based upon radiological, clinical and pathological features. In a selected cohort of patients, radiological invasion resulted in the most common marker to describe the aggressive behaviour of pituitary adenoma. Surgery, radiotherapy and medical treatment (the latter only in secreting adenoma) achieved disease control in half of the patients with aggressive adenoma, especially surgery in those with ACTH-oma and medical treatment in those with GH- and PRL-secreting adenoma. Nevertheless, radiological, clinical or atypical features did ...
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

Decompressive hemicraniectomy for malignant middle cerebral artery infarction including patients with additional involvement of the anterior and/or posterior cerebral artery territory —outcome analysis and definition of prognostic factors
AbstractBackgroundAccording to current evidence, adding decompressive craniectomy (DC) to best medical therapy reduces case fatality rate of malignant middle cerebral artery infarction by 50 –75%. There is currently little information available regarding the outcome of subgroups, in particular of patients with extensive infarctions exceeding the territory of the middle cerebral artery.MethodsThe records of 101 patients with large hemispheric infarctions undergoing DC were retrospectively reviewed. Twenty-seven patients had additional ACA and/or PCA infarcts. Sequential CTs were used for postoperative follow-up. Intra...
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

Letter from the President of the EANS
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 18, 2017 Category: Neurosurgery Source Type: research

Cognitive improvement following repair of a basal encephalocele
We report the case of a 55-year-old woman presenting with progressive memory impairment secondary to a transsphenoidal encephalocele involving her dominant medial temporal lobe. Her clinical deterioration was accompanied by radiological progression in the encephalocele's size and associated encephalomalacia. Through a temporal craniotomy, her encephalocele was resected and the defect closed. Baseline neuropsychological assessment indicated global cognitive impairment, but post-operatively, she reported improved memory and concentration. Standardized assessment reflected an improvement in perceptual skills and an associated...
Source: Acta Neurochirurgica - December 17, 2017 Category: Neurosurgery Source Type: research

Innovation in neurosurgery response to: “Ideal”, the operating microscope, and the parachute
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 17, 2017 Category: Neurosurgery Source Type: research

Effects of bilateral pallidal deep brain stimulation on chorea after pulmonary thromboendarterectomy with deep hypothermia and circulatory arrest: a case report
AbstractA 41-year-old man was diagnosed with chronic pulmonary thromboembolism and underwent pulmonary thromboendarterectomy (PTE) with deep hypothermia and circulatory arrest. Five days after the operation, chorea emerged in the lower extremities. The patient was referred to our hospital for disabling chorea 16  years after PTE. Neurological examination revealed choreatic movements in the four extremities. Brain magnetic resonance images indicated atrophy in the bilateral head of the caudate nuclei. The patient underwent deep brain stimulation (DBS) of the bilateral globus pallidus interna (GPi). Continuo us GPi-DBS ...
Source: Acta Neurochirurgica - December 16, 2017 Category: Neurosurgery Source Type: research

Spontaneous healing of a shredded esophagus after ACDF without direct repair
AbstractEsophageal perforation is a catastrophic complication of anterior cervical discectomy and fusion (ACDF). While direct surgical repair has been reported as optimal for restoration of upper gut function, we present the case of a 58-year-old woman who achieved complete resolution when treated only with debridement and drainage. We find that a supportive approach, surgical management without direct repair, may play a vital role in select patient populations in order to avoid potentially long-term consequences or radical treatments, like esophageal diversion. Decisions regarding direct repair versus debridement and insp...
Source: Acta Neurochirurgica - December 16, 2017 Category: Neurosurgery Source Type: research

Innovation in neurosurgery —response to: “IDEAL”, the operating microscope, and the parachute
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 15, 2017 Category: Neurosurgery Source Type: research

Decompressive craniectomy in traumatic brain injury: usage and clinical outcome in a single centre
ConclusionsThe place for DC in TBI management must be evaluated better, and we believe it is important that future RCTs should have clearer and less permissive ICP criteria regarding when thiopental should be followed by DC and DC followed by thiopental. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 12, 2017 Category: Neurosurgery Source Type: research

Non-functionalized soft alginate hydrogel promotes locomotor recovery after spinal cord injury in a rat hemimyelonectomy model
ConclusionsImplantation of soft alginate hydrogel in small spinal cord lesions improved functional recovery. Possible underlying mechanisms include the mechanical stabilization of the wound, reduction of secondary damage and inhibition of fibrous scarring. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - December 11, 2017 Category: Neurosurgery Source Type: research

Aphasia and cognitive impairment decrease the reliability of rnTMS language mapping
AbstractBackgroundNavigated transcranial magnetic stimulation (nTMS) is a non-invasive mapping tool to locate functional areas of the brain. While gaining importance in the preoperative planning process in motor eloquent regions, its usefulness for reliably identifying language areas is still being discussed. The aim of this study was to identify biometric factors which might influence and therefore bias the results of repetitive nTMS (rnTMS) over cortex areas relevant for language.MethodWe included data of 101 patients with language eloquent brain lesions who underwent preoperative rnTMS examination bihemispherically. Pri...
Source: Acta Neurochirurgica - December 9, 2017 Category: Neurosurgery Source Type: research

Bipolar dual-lead spinal cord stimulation between two electrodes on the ventral and dorsal sides of the spinal cord: consideration of putative mechanisms
AbstractWe have applied bipolar dual-lead spinal cord stimulation (SCS) between two cylinder-type electrodes placed on the ventral and dorsal sides of the spinal cord (dual-VD-SCS). A 36-year-old man suffered from burning pain from his right elbow down to his hand after brachial plexus avulsion. The areas with paresthesia induced by conventional SCS did not include the painful hand area. However, dual-VD-SCS completely induced paresthesia in the painful hand area. We speculate that dual-VD-SCS can be applied to stimulate deeper sites of the dorsal column and dorsal horn than conventional SCS and is useful for pain reductio...
Source: Acta Neurochirurgica - December 9, 2017 Category: Neurosurgery Source Type: research

Technical accuracy of the integration of an external ultrasonography system into a navigation platform: effects of ultrasonography probe registration and target detection
AbstractBackgroundIntraoperative navigated ultrasonography has reached clinical acceptance, while published data for the accuracy of some systems are missing. We technically quantified and optimised the accuracy of the integration of an external ultrasonography system into a BrainLab navigation system.MethodsA high-end ultrasonography system (Elegra; Siemens, Erlangen, Germany) was linked to a navigation system (Vector Vision; BrainLab, Munich, Germany). In vitro accuracy and precision was calculated from differences between a real world target (high-precision crosshair phantom) and the ultrasonography image of this target...
Source: Acta Neurochirurgica - December 8, 2017 Category: Neurosurgery Source Type: research