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   You are here: Home ›› Archive ›› Vol. XVI, no. 2

Towards a better future in profession and life for women neurosurgeons and their patients
Yoko Kato
Department of Neurosurgery, Fujita Health University, Japan
Keywords: neurosurgery, neurosurgeon, women, professional

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Cerebral cavernomas in the adult
Review of the literature and analysis of 61 surgically treated patients
Angela Neacsu MD, Prof. Radu Mircea Gorgan MD PHD, Narcisa Bucur MD PHD, Mihai Viorel Pruna MD
First Neurosurgical Clinic, Fourth Neurosurgical Department Clinic Emergency Hospital “Bagdasar-Arseni”, Bucharest
Keywords: cavernous angioma, cavernomas, epilepsy, hemorrhage, surgery

Background and Purpose. Authors review the latest data regarding modern, multimodal management of single and multiple intracranial cavernomas, based on their experience, on a consecutive series of 61 cases. Methods. During 2001 to 2009, 61 patients (33 men, 28 women) with intracerebral cavernous angiomas underwent surgical treatment in our center, and they were included into the present uncontrolled clinical study. The average age of the patients at the time of operation was 41.4 years. All patients underwent preoperative magnetic resonance imaging, and pre and postoperative clinical examination. The clinical course was documented using the Karnofski performance scale. A simplified version of Engel’s classification of the outcome of the patients with chronic seizures was applied. Results. The most common clinical presentation of cavernous angiomas was seizures, significant part of which was chronic. In the group of patients presenting with headache, sporadic seizures, or intracerebral hemorrhage, good postoperative outcome was achieved in 86.84% of the patients. Of the patients who underwent operation for seizure control, significant seizure reduction or elimination after surgery was observed in 80,95% of the patients. Conclusions. Cavernomas are benign lesions, surgically resectable; the excision must be complete, any rests causing re-bleeding. Microsurgical removal of cavernous angiomas and surrounding hemosiderin plate tends to significant reduction or elimination of epileptic seizures and improved postoperative neurological status.

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Intracranial pressure monitoring study in severe traumatic brain injury and post-traumatic hydrocephalus
Dr. St.M. Iencean1, Prof. Dr. N. Ianovici2, Prof. Dr. A.V. Ciurea3
1Neurosurgery, Hospital “Prof. Dr. N. Oblu” Iasi
2University of Medicine and Pharmacy “Gr.T. Popa”, Hospital “Prof. Dr. N. Oblu” Iasi
3University of Medicine and Pharmacy “Carol Davila”, Emergency Clinic Hospital “Bagdasar-Arseni” Bucharest
Keywords: post-traumatic hydrocephalus, intracranial pressure, traumatic brain injury

Objective. To evaluate patients who developed hydrocephalus following a severe traumatic brain injury in connection with the monitoring of intracranial pressure (ICP) during the acute stage of brain trauma. Methods. There were studied 25 patients with severe head injuries and GCS score of 7 to 4, age between 20 and 60 years, who underwent ICP monitoring and cerebral perfusion pressure (CPP) monitoring. Sixteen surviving patients were followed for 12 months and the development of the post–traumatic hydrocephalus was found at five patients. Conclusions. The analysis of the data of this study shows some observations: Mortality in severe traumatic brain injuries is correlated with a low GCS score, high ICP values and arterial hypotension. The favorable outcome is in connection with a high initial GCS score, a decrease of ICP and normal values of cerebral perfusion pressure. There were five cases of moderate post-traumatic hydrocephalus and these cases of hydrocephalus have stabilized and did not need a surgical intervention.

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Decompressive craniectomy – from option to standard - part I
Corneliu Balan1, Bernard Alliez2
1Clinical Hospital “Prof. Dr. N. Oblu”, Iasi, Romania
2Hopital Nord, CHU Marseille, France
Keywords: decompressive craniectomy, indications

Authors intend an update to the theoretical and practical data on a seldom utilized technique but often considered as last therapeutically option, so the necessity to realize it correctly. The authors present the history, the physiopathology of the technique, the surgical steps and options, together with details on the complications, surgical indications.

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1-year experience with solis peek cages in cervical discectomy and fusion
C.E. Popescu1, Jan-Uwe Muller2, B. Costachescu1
1Clinical Hospital “Prof. Dr. N. Oblu”, Neurosurgical Department
2Department of Neurosurgery, Ernst-Moritz-Arndt University, Greifswald, Germany
Keywords: interbody fusion, cervical disc, peek cage

Objective. This study evaluates the efficacy of peek cages in interbody fusion in 32 consecutive patients treated for cervical disc herniation. Methods: During one-year period, 32 patients were treated in our Department for cervical disc disease using interbody fusion with peek cages There were 19 men and 13 women, aged between 33 and 68 years (mean 44 years). We used autologus cancelous bone for cage packing and no plate fixation. The mean follow-up was 12 months. Results: We judged the success of surgery using the following criteria: recovery of neurological function/radiculopathy, positioning of the cage, extent of fusion at 1-year follow-up, and return to work. Conclusion: The use of peek cages in interbody fusion for the treatment of cervical disc disease seems to be a good alternative to classic ACDF using tricortical bone graft.

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Subperiosteal and intraconal haematoma associated with frontal and subfrontal extradural haematoma Case report
D. Balasa1, A. Tunas1, M. Bardas2, G. Butoi2, S. Daniela3
1Department of Neurosurgery
2Department of Radiology
3Department of Neurology Clinical Emergency Hospital Constanta
Keywords: subperiostal hematoma, head trauma, extradural haematoma

Intraorbital subperiostal haematoma is a rare entity described in the radiology, ophthalmology and neurosurgical literature produced in most of the cases by head traumas. The authors present the case of a woman suffered a car accident that caused deep coma, bilateral exophtalmia with dominance in the right eye, left hemiparesis. CT scan of the head showed DAI, huge extradural right front temporal haematoma, subperiostal and intraorbital haematoma in the right orbit, intraventricular hemorrhage, falx cerebelli hemorrhage, fracture of the etmoidal bone with etmoid haemosinus. It was done emergent successful surgical removal of the epidural haematoma, and partial removal of the subperiostal and intraorbital haematoma by trepanation of the orbit on the fracture site. Postoperative evolution was eventless and control CT Scan showed healed radiologically.

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Selected abstracts from Annual National Conference of the Romanian Society of Neurosurgery
with International Participation
September 29th - October 3rd, 2009, Sibiu, Romania
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