Clinical application of a new bioabsorbable artificial dura mater

2002 ◽  
Vol 96 (4) ◽  
pp. 731-735 ◽  
Author(s):  
Keisuke Yamada ◽  
Susumu Miyamoto ◽  
Motohiro Takayama ◽  
Izumi Nagata ◽  
Nobuo Hashimoto ◽  
...  
Keyword(s):  
Dura Mater ◽  
Latent Infection ◽  
Neurosurgical Procedures ◽  
Resonance Imaging ◽  
Content Type ◽  
Dural Substitute ◽  
Collagenous Tissue ◽  
Foreign Body Reactions ◽  
Fine Print

Object. In their pursuit of a better substitute for dura mater in neurosurgical procedures, the authors review their experience with GM972. Methods. A newly developed synthetic dural substitute composed of bioabsorbable polymers (GM972) was placed in 53 patients during neurosurgical procedures. The handling properties of the material, surgical wound features, and findings of hematological, computerized tomography, and/or magnetic resonance imaging examinations were evaluated. The average follow-up period was 35.5 months. The handling properties and biocompatibility of this new dural substitute were highly satisfactory, and no significant complication was observed. In patients who underwent a second surgery performed more than 18 months after the initial operation, this new dural substitute was found to have been replaced by autologous collagenous tissue. Because of its bioabsorbability, chronic foreign body reactions to this synthetic dural substitute were negligible. Conclusions. In this report the authors support the effectiveness and safety of this bioabsorbable artificial dural substitute that provides a reduced risk of transmission of latent infection.

Fetal meningeal hemangiopericytoma

2002 ◽  
Vol 97 (5) ◽  
pp. 1217-1220 ◽  
Author(s):  
Sergio Cavalheiro ◽  
Fábio Veiga de Castro Sparapani ◽  
Antonio Fernandes Moron ◽  
Marcia Cristina da Silva ◽  
João Norberto Stávale
Keyword(s):  
Magnetic Resonance Imaging ◽  
Complete Resection ◽  
Prenatal Period ◽  
Resonance Imaging ◽  
Content Type ◽  
Abdominal Magnetic Resonance Imaging ◽  
Meningeal Hemangiopericytoma ◽  
Tomography Scanning ◽  
Fine Print

✓ The authors present the case of a 34-week-old fetus with a meningeal hemangiopericytoma that was diagnosed in utero by using abdominal magnetic resonance imaging. After birth, the neonate underwent transfontanelle ultrasonography and computerized tomography scanning of the head, which confirmed the presence of an extradural hyperdense lesion. Six hours after birth the neonate underwent a craniotomy, which resulted in complete resection of the mass. The postoperative period was uneventful and the newborn was discharged 7 days later. At 2-year follow-up examination there was no evidence of recurrence of the lesion. The authors have found no mention in the literature of this entity diagnosed in the prenatal period.

Magnetic resonance imaging—compatible posterior cervical implant for occipitocervical stabilization

1998 ◽  
Vol 89 (5) ◽  
pp. 852-856 ◽  
Author(s):  
H. Alan Crockard ◽  
Ahmed Tammam ◽  
Nigel Mendoza
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Content Type ◽  
Occipitocervical Fixation ◽  
Fine Print

✓ Posterior cervical stabilization was accomplished in 30 patients (19 females and 11 males) by using sublaminar titanium cables and a new titanium bullet-shaped implant. Seventeen patients underwent occipitocervical fixation and 13 others were treated subaxially. These patients have been followed for 18 to 52 months (mean 36 months), and no implant has failed during the follow-up period.

Xenogeneic pericardium as a dural substitute in reconstruction of suboccipital dura mater in children

1989 ◽  
Vol 70 (6) ◽  
pp. 905-909 ◽  
Author(s):  
Jan Pařízek ◽  
Pavel Měřička ◽  
Josef Špaček ◽  
Stanislav Němeček ◽  
Pavel Eliáš ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Dura Mater ◽  
Light And Electron Microscopy ◽  
Fascia Lata ◽  
Content Type ◽  
Dural Substitute ◽  
Freeze Dried ◽  
Materials Used ◽  
Neurosurgical Techniques ◽  
Fine Print

✓ A 5-year experience with the glutaraldehyde-stabilized freeze-dried radiation-sterilized calf pericardium used as a dural substitute is reported. The structure of pericardium xenograft is compared with other collagenous materials used for duraplasty (allogeneic fascia lata and dura mater) by light and electron microscopy. The special neurosurgical techniques involved in using pericardium xenografts in the reconstruction of suboccipital dura mater in children are presented in detail.

Growth rate of incidental meningiomas

1990 ◽  
Vol 73 (4) ◽  
pp. 545-547 ◽  
Author(s):  
Raimund P. Firsching ◽  
Anette Fischer ◽  
Reinhard Peters ◽  
Frank Thun ◽  
Norfrid Klug
Keyword(s):  
Magnetic Resonance Imaging ◽  
Growth Rate ◽  
Clinical Signs ◽  
Ct Scans ◽  
Tumor Growth Rate ◽  
Annual Growth Rate ◽  
Resonance Imaging ◽  
Content Type ◽  
Fine Print

✓ A meningioma was incidentally identified with computerized tomography (CT) in 17 patients without relevant clinical signs. The tumor was not removed, but biopsy confirming a meningioma was obtained from one patient. Tumor growth rate was calculated from repeat CT scans or follow-up magnetic resonance imaging. The annual growth rate ranged from less than 1% to 21%. It is concluded that in nonsymptomatic meningiomas with a low growth rate a nonsurgical approach may be warranted.

Adult intramedullary spinal cord ependymomas: the result of surgery in 38 patients

1993 ◽  
Vol 79 (2) ◽  
pp. 204-209 ◽  
Author(s):  
Fred J. Epstein ◽  
Jean-Pierre Farmer ◽  
Diana Freed
Keyword(s):  
Spinal Cord ◽  
Tumor Recurrence ◽  
Resonance Imaging ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Postoperative Magnetic Resonance Imaging ◽  
Significant Disability ◽  
Surgical Adjunct ◽  
Fine Print

✓ Thirty-eight patients underwent surgery for an intramedullary spinal cord ependymoma. In 37 patients, postoperative magnetic resonance imaging confirmed that the tumor was totally removed. The morbidity of surgery was directly related to the preoperative neurological condition. Patients who were normal or nearly normal preoperatively were rarely worse after surgery, and those who had significant disability preoperatively were at greatest risk of being more impaired after surgery. There has been no tumor recurrence in any patient after a mean follow-up period of 24 months, and radiation therapy has not been employed as a surgical adjunct.

Initial experience with gamma knife surgery for endocrine ophthalmopathy

2005 ◽  
Vol 102 ◽  
pp. 272-275
Author(s):  
Julio C. Antico ◽  
Luis Crovetto ◽  
Eduardo Tenca ◽  
Carlos Artes
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Content Type ◽  
Soft Tissue Involvement ◽  
Endocrine Ophthalmopathy ◽  
A Prospective Study ◽  
Fine Print

Object. The aim of this study was to evaluate both the effectiveness and safety of the treatment of endocrine ophthalmopathy with gamma knife surgery (GKS). Methods. Five patients were included in a prospective study designed to assess the results of GKS of endocrine ophthalmopathy secondary to Graves disease. All the patients completed a 2-year follow-up period. During this period, the patients were evaluated both clinically and by means of additional methods, including computerized tomography and magnetic resonance imaging studies. The minimum dose delivered to the 50% isodose line was 6.5 Gy in all the patients. In all cases, a clinical improvement was observed. The best effect was seen in symptom regression related to soft-tissue involvement. No treatment-related side effects were detected. Conclusions. In light of the results obtained the authors consider that GKS may be a safe and effective way to treat endocrine ophthalmopathy.

Carcinomatous meningitis: are surgery or gamma knife radiosurgery treatment risk factors?

2002 ◽  
Vol 97 ◽  
pp. 441-444 ◽  
Author(s):  
Anita Mahajan ◽  
Jonathan Borden ◽  
Jen-san Tsai
Keyword(s):  
Risk Factors ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Primary Lung Cancer ◽  
Carcinomatous Meningitis ◽  
Resonance Imaging ◽  
Content Type ◽  
Potential Risk Factors ◽  
Fine Print

Object. The purpose of this study was to identify possible risk factors leading to carcinomatous meningitis in patients with a known brain metastasis and who were treated with gamma knife radiosurgery (GKS). Methods. Two hundred eighty lesions in 101 patients were treated during 121 GKS procedures. The clinical and neuroimaging history, tumor histology, and follow-up studies were reviewed for all patients. Evidence as demonstrated by magnetic resonance imaging criteria and/or cerebrospinal fluid (CSF) cytology of carcinomatous meningitis was evaluated. The data were then analyzed to identify potential risk factors for the development of CSF dissemination. Conclusions. It appears that carcinomatous meningitis is exclusively identified in patients with adenocarcinoma, in particular with primary lung cancer. Furthermore, the incidence is higher if surgery is performed and the interval to subsequent GKS is prolonged.

Initial experience with gamma knife surgery for endocrine ophthalmopathy

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 272-275
Author(s):  
Julio C. Antico ◽  
Luis Crovetto ◽  
Eduardo Tenca ◽  
Carlos Artes
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Content Type ◽  
Soft Tissue Involvement ◽  
Endocrine Ophthalmopathy ◽  
A Prospective Study ◽  
Fine Print

Object. The aim of this study was to evaluate both the effectiveness and safety of the treatment of endocrine ophthalmopathy with gamma knife surgery (GKS). Methods. Five patients were included in a prospective study designed to assess the results of GKS of endocrine ophthalmopathy secondary to Graves disease. All the patients completed a 2-year follow-up period. During this period, the patients were evaluated both clinically and by means of additional methods, including computerized tomography and magnetic resonance imaging studies. The minimum dose delivered to the 50% isodose line was 6.5 Gy in all the patients. In all cases, a clinical improvement was observed. The best effect was seen in symptom regression related to soft-tissue involvement. No treatment-related side effects were detected. Conclusions. In light of the results obtained the authors consider that GKS may be a safe and effective way to treat endocrine ophthalmopathy.

Magnetic resonance imaging: an accurate method to evaluate arteriovenous malformations after stereotactic radiosurgery

1996 ◽  
Vol 85 (6) ◽  
pp. 1044-1049 ◽  
Author(s):  
Bruce E. Pollock ◽  
Douglas Kondziolka ◽  
John C. Flickinger ◽  
Atul K. Patel ◽  
David J. Bissonette ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Cerebral Angiography ◽  
False Negative ◽  
Resonance Imaging ◽  
Mr Images ◽  
Content Type ◽  
Fine Print

✓ To determine the accuracy of magnetic resonance (MR) imaging in comparison to cerebral angiography after radiosurgery for an arteriovenous malformation (AVM), the authors reviewed the records of patients who underwent radiosurgery at the University of Pittsburgh Medical Center before 1992. All patients in the analysis had AVMs in which the flow-void signal was visible on preradiosurgical MR imaging. One hundred sixty-four postradiosurgical angiograms were obtained in 140 patients at a median of 2 months after postradiosurgical MR imaging (median 24 months after radiosurgery). Magnetic resonance imaging correctly predicted patency in 64 of 80 patients in whom patent AVMs were seen on follow-up angiography (sensitivity 80%) and angiographic obliteration in 84 of 84 patients (specificity 100%). Overall, 84 of 100 AVMs in which evidence of obliteration was seen on MR images displayed angiographic obliteration (negative predictive value, 84%). Ten of the 16 patients with false-negative MR images underwent follow-up angiography: in seven the lesions progressed to complete angiographic obliteration without further treatment. Exclusion of these seven patients from the false-negative MR imaging group increases the predictive value of a negative postradiosurgical MR image from 84% to 91%. No AVM hemorrhage was observed in clinical follow up of 135 patients after evidence of obliteration on MR imaging (median follow-up interval 35 months; range 2–96 months; total follow up 382 patient-years). Magnetic resonance imaging proved to be an accurate, noninvasive method for evaluating the patency of AVMs that were identifiable on MR imaging after stereotactic radiosurgery. This imaging modality is less expensive, more acceptable to patients, and does not have the potential for neurological complications that may be associated with cerebral angiography. The risk associated with follow-up cerebral angiography may no longer justify its role in the assessment of radiosurgical results in the treatment of AVMs.

Successful radical removal of an intracranial meningioma in 1835 by Professor Pecchioli of Siena

1984 ◽  
Vol 60 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Renato Giuffrè
Keyword(s):  
Dura Mater ◽  
Intracranial Meningioma ◽  
Content Type ◽  
Bone Surgery ◽  
Radical Removal ◽  
University Of Paris ◽  
The Right ◽  
The University ◽  
Fine Print

✓ In 1835, Pecchioli, Professor of Surgery and Operating Medicine at the University of Siena, removed a “fungus of the dura mater” (meningioma). The lesion was a large ulcerated cranial outgrowth at the level of the right sinciput, which at operation proved to originate from the dura mater and to be eroding the bone. Surgery was radical. The patient recovered and attended for follow-up review several times in the course of 30 months, always fit and with no sign of recurrence. This procedure was later selected for the competition for the chair of Surgery at the University of Paris in 1840. In 1847, Pecchioli summarized his surgical material spanning 16 years' activity, including neurosurgical operations.

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