By B. L. Bauer (auth.), Prof. Dr. Bernhard L. Bauer, Prof. Dr. Dr. h.c. Mario Brock, Prof. Dr. Margareta Klinger (eds.)
ISBN-10: 3540576681
ISBN-13: 9783540576686
ISBN-10: 3642788017
ISBN-13: 9783642788017
Advances in Neurosurgery 22 is dedicated to 3 major subject matters, the 1st one being Cerebellar Infarcts. Following the advent with the microsurgical anatomy and the neuropathology of cerebellar infarction, the indication for operative remedy and its effects are then mentioned. The neuroradiological therapy with neighborhood and antifibrinolytic treatment for vertebrobasilar occlusion completes this part. The administration and surgical methods to a number of the types of midline lesions are then offered. certain curiosity is concentrated on minimum invasive endoscopic neurosurgery (MIEN), (intraventricular tumors, optic pathway gliomas, endoscopic brainstem tumors and vascular malformations). in addition the certain apparatus and fields of symptoms are generally mentioned.
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Additional resources for Cerebellar Infarct. Midline Tumors. Minimally Invasive Endoscopic Neurosurgery (MIEN)
Sample text
This retrospective study reports our experiences in the surgical treatment of patients with space-occupying cerebellar infarctions, especially suboccipital craniectomy, with special consideration of the long-term outcome. Patients and Methods Data collected from all patients with space-occupying cerebellar infarctions treated surgically in the Department of Neurosurgery of the University of Giessen from 1981 to 1992 were reviewed retrospectively. Clinical features that were analyzed included especially the level of consciousness as determined by the Glasgow Coma Scale, imaging studies with computed tomography, operative and intraoperative findings, pre- and postoperative course, and outcome at discharge from our institution as measured by Glasgow Outcome Scale (GOS).
Conclusion The most important parameter in considering appropriate therapy in cerebellar infarction seems to be the neurological status of the patient, with special reference to the level of consciousness. In many cases of nearly asymptomatic infarction, conscious patients do not need any operative treatment. On the other hand, a frontal burrhole for emergency ventriculostomy should be considered [2]. In unconscious patients ventriculostomy seems appropriate in any case. However, instead of uncontrollable CSF drainage a continuous monitoring of intracranial pressure should be performed.
Our own results in the 24 cases of operated intra-/ peri ventricular lesions confinn these opinions expressed in the literature in all points. Conclusion We therefore conclude that with a strict preoperative and microsurgical rationale the interhemispheric preparation itself poses no problem. Despite a high incidence of transient postoperative morbidity and an often slow recovery, the long-tenn results of the interhemispheric transcallosal approach are very good. The outcome is closely related to preoperative status, tumor size, localization, and histology, but not to the site of callosotomy.