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[Contribution of neuroradiology to the evaluation of peripheral nerves.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The evaluation of peripheral nerve impairment can use echography, MRI and CT. The alteration of the nerves in tunnel syndromes, especially if symptoms are not sufficiently contributive, is clearly visualized with MRI. Echography is very useful in the diagnosis of nerve tumors and neuromas. Plexus brachial palsies need to be evaluated using MRI. Progress in neuroimaging has improved clinical practice so that the most relevant treatment can be chosen for some pathologies such as infiltration performed under CT scanner guidance. The authors report which exam to use and the results to be expected for each pathology. PM...
Source: Neuro-Chirurgie - October 4, 2009 Category: Neurosurgery Authors: Chan M, Pesquer L, Vandermarcq P Tags: Neurochirurgie Source Type: journals

[Anatomic bases of surgical approaches to the nerves of the lower limb: Tips for young surgeons.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
For trainee surgeons, the surgical approaches of the lower limb's peripheral nerves remain partially or completely unknown, but traumatic nerve lesions are rather frequent at this level and nerve tumors require intervention. Young surgeons will also have to treat spasticity and perform selective neurotomies, which can provide dramatic improvement of the functional status of properly selected patients. Excellent knowledge of anatomy is the key point to successful surgery. For each nerve approach, the key points on the morphological data of the nerve and its surroundings are given, as are the typical indications for this...
Source: Neuro-Chirurgie - September 30, 2009 Category: Neurosurgery Authors: Rigoard P, Buffenoir-Billet K, Giot JP, d'Houtaud S, Delmotte A, Lapierre F Tags: Neurochirurgie Source Type: journals

[Thoracic outlet syndromes.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Thoracic outlet syndromes (TOS) may induce neurologic signs, vascular pathology, and pain, but the clinical signs are often unclear. The relationship between a cervical bony abnormality is often unclear, and the investigations not always contributive. First-line treatment consists in physiotherapy. Surgery remains controversial, in both its indication as its modalities. However, well-adapted surgery gives a good result in 60-85% of cases. PMID: 19800643 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - September 30, 2009 Category: Neurosurgery Authors: Gilbert A Tags: Neurochirurgie Source Type: journals

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Neurochirurgie. 2009 Sep 30; Authors: Lapierre F PMID: 19800086 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - September 29, 2009 Category: Neurosurgery Authors: Lapierre F Tags: Neurochirurgie Source Type: journals

[The main tunnel syndromes.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Several tunnel syndromes are responsible for substantial functional impairment. The diagnosis has to be made and treatment is most often very simple - nerve decompression - with excellent results. Of these syndromes, the most common are median and ulnar tunnel syndromes of the wrist and ulnar tunnel syndrome of the elbow, but other syndromes must be identified at the risk of therapy failure due to poorly adapted treatment. Finally, good knowledge of this pathology must lead to prevention of the iatrogenic forms (sequelae of inguinal hernia treatment, ileac crest graft harvesting) by educating all surgeons interested in...
Source: Neuro-Chirurgie - September 29, 2009 Category: Neurosurgery Authors: Lapierre F, Buffenoir K, Giot JP, Delmotte A, Rigoard P Tags: Neurochirurgie Source Type: journals

[Peripheral nerve tumors.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Peripheral nerve tumors are most often benign tumors of the nerve sheath; uncommonly they come from the nerve cells or are metastatic tumors. A precise diagnosis is required for well-adapted and effective treatment, as is good knowledge of fibromatosis diseases. In some cases, the diagnosis of the nerve tumor will lead to a diagnosis of phakomatosis. Surgical treatment must be clearly discussed, which, in case of schwannomas gives very good functional results. Primitive malignant tumors remain an unsolved therapeutic problem. PMID: 19796780 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - September 28, 2009 Category: Neurosurgery Authors: Lapierre F, Rigoard P, Wager M Tags: Neurochirurgie Source Type: journals

[Management and results of treating obstetrical palsy in the new-born.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Birth injuries to the brachial plexus have not disappeared in spite of improvements in obstetrics. Many of these palsies spontaneously recover but some will require a surgical approach. Over the last 30 years, the author has explored and repaired 1026 brachial plexus injuries in infants who had not recovered biceps function after three months. Repair is always feasible and its results far better than spontaneous progression. The results are evaluated after 20 years of follow-up for some patients. Their evaluation confirms the importance of early plexus surgery. PMID: 19793598 [PubMed - as supplied by publisher] (So...
Source: Neuro-Chirurgie - September 27, 2009 Category: Neurosurgery Authors: Gilbert A Tags: Neurochirurgie Source Type: journals

[Peripheral nerve surgery in leprosy.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Leprosy has nearly disappeared in France but continues to affect two million patients in the world. Involvement of the peripheral nerve must be identified and requires surgical treatment, which can provide good results for pain and function. The author reviews the most frequently affected peripheral nerves and reports her personal series, with surgery performed concomitantly with the medical treatment of the disease. PMID: 19793599 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - September 27, 2009 Category: Neurosurgery Authors: Redondo A Tags: Neurochirurgie Source Type: journals

[Anatomic bases of surgical approaches to the nerves of the upper limb: Tips for young surgeons.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Peripheral nerve surgery requires a certain level of specialization. Surgeons must have solid knowledge of morphological anatomy of the different segments to be explored, decompressed, repaired, or even neurotized. This paper describes the most common approaches to the peripheral nerves of the upper limb. PMID: 19783016 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - September 24, 2009 Category: Neurosurgery Authors: Rigoard P, Buffenoir-Billet K, Giot JP, Delmotte A, d'houtaud S, Lapierre F Tags: Neurochirurgie Source Type: journals

[Review of the peripheral nerve.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The peripheral nerve provides the pathway for motor, sensory, and vegetative axons belonging to the peripheral nervous system. It transmits information between these neurons and their peripheral effectors in both directions (sensory receptors, skeletal muscles, and viscera). The afferences to the periphery correspond to the nerve motor content, whereas efferences from the periphery, in charge of delivering information to the central integrators, correspond to nerve-sensitive content. This information support depends on the intrinsic properties of the nerve itself. Peripheral nerve injuries are frequent and generate sig...
Source: Neuro-Chirurgie - September 24, 2009 Category: Neurosurgery Authors: Rigoard P, Lapierre F Tags: Neurochirurgie Source Type: journals

[The pudendal nerve: Clinical and therapeutic morphogenesis, anatomy, and physiopathology.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The pudendal is the king of the perineum. Most often originating in the S3 root, it is responsible for the teguments of the perineum (glans penis, clitoris, scrotum, and the labia majora, the skin of the central fibrous perineal body, anus), but also the erector muscles and the striated sphincters. The social nerve, it controls erection and the voluntary sphincters. It is also the nerve of the beginnings of sexual sensation and masturbation. Its injury is expressed in perineal pain, which, when positional, suggests a tunnel syndrome. The compression points have become well known: ligament pinching between the sacrotube...
Source: Neuro-Chirurgie - September 10, 2009 Category: Neurosurgery Authors: Robert R, Labat JJ, Riant T, Louppe JM, Hamel O Tags: Neurochirurgie Source Type: journals

[Electrophysiological exploration of tunnel syndromes.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The compressive neuropathies often lead to segmental demyelination injury. These injuries can be detected using speed motor conduction and sensitivity conduction. The corresponding abnormalities are localized conduction abnormalities, presenting as deceleration or as a conductive block. Segmentary deceleration is perfectly well observed, such as in cases of carpal tunnel syndrome. The detection examination, recording motor unit potentials, can distinguish between a peripheral injury and a central injury as well as between a neurogenic injury and a myogenous injury. The precise study of the sensitivity potentials makes ...
Source: Neuro-Chirurgie - September 9, 2009 Category: Neurosurgery Authors: Dumas P Tags: Neurochirurgie Source Type: journals

[Somatic perineal pain other than pudendal neuralgia.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In addition to the well-established syndrome of pudendal compression, and given the rich nerve trunk innervation of the perineum, pain originating in other nerve trunks can occur and must be remembered. Nerves originating high in the thoracolumbar area (ilioinguinal nerve, iliohypogastric nerve, genitor femoral nerve) can be the seat of traumatic lesions occurring during surgical approaches through the abdominal wall or can undergo compressions when crossing the fascia of the large abdominal muscles. Misleading perineal irradiations do not resemble pudendal neuralgia and should suggest pain in these trunks whose cutane...
Source: Neuro-Chirurgie - September 7, 2009 Category: Neurosurgery Authors: Robert R, Labat JJ, Riant T, Louppe JM, Lucas O, Hamel O Tags: Neurochirurgie Source Type: journals

[Pathologic characteristics of the most frequent peripheral nerve tumors.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Benign tumors of the peripheral nerves come from ectodermic tissues. This chapter describes the most common forms: the schwannomas and the neurofibromas. Schwannomas have two possible patterns of cells: Antoni A and B types. Neurofibromas are most often associated with neurofibromatosis NF(1) and may be localized, diffuse, or plexiform. The benign tumor structures account for the fact that they can be removed with or without preserving the concerned nerve. Malignant tumors (malignant peripheral sheath tumors) come from degeneration of neurofibromas in two out of three cases and have a poor prognosis. PMID: 19744677...
Source: Neuro-Chirurgie - September 7, 2009 Category: Neurosurgery Authors: Coulon A, Milin S, Laban E, Debiais C, Jamet C, Goujon JM Tags: Neurochirurgie Source Type: journals

[Buttocks sciatic pain.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Confusion between radicular and nerve trunk syndrome is not rare. With sciatic pain, any nerve trunk pain or an atypical nerve course should suggest nerve trunk pain of the sciatic nerve in the buttocks. The usual reflex with sciatic pain is vertebral-radicular conflict. The absence of spinal symptoms and the beginning of pain in the buttocks and not in the lumbar region should reorient the etiologic search. Once a tumor of the nerve trunk has been ruled out (rarely responsible for pain other than that caused by tumor pressure), a myofascial syndrome should be explored searching for clinical, electrophysiological, and ...
Source: Neuro-Chirurgie - September 7, 2009 Category: Neurosurgery Authors: Labat JJ, Robert R, Riant T, Louppe JM, Lucas O, Hamel O Tags: Neurochirurgie Source Type: journals

[Endoscopy versus microsurgery: Results in a consecutive series of nonfunctioning pituitary adenomas.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Microsurgical removal of nonfunctioning pituitary adenomas (NFPAs) is often subtotal. Removing the blind spots as viewed through the microscope, endoscopic surgery may improve the quality of removal. Our purpose was to compare the results of the two techniques in a series of NFPA patients operated on by a single surgeon. Thirty-six patients with newly diagnosed NFPAs were operated on using a purely endoscopic procedure and 29 with a microsurgical technique. All patients were explored pre- and postoperatively (at 3 and 6 months and then every 12 months) by endocrine assays, ophthalmologic exam, and 3D MRI. The endocrine...
Source: Neuro-Chirurgie - September 2, 2009 Category: Neurosurgery Authors: Kassis S, De Battista JC, G GR, Jacob M, Simon E, Rabilloud M, Froehlich P, Trouillas J, Borson-Chazot F, Perrin G, Jouanneau E Tags: Neurochirurgie Source Type: journals

[Odontoid process fracture in elderly patients over 70 years: Morbidity, handicap, and role of surgical treatment in a retrospective series of 27 cases.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSIONS: Odontoid fractures in the elderly are a very frequent problem. Immediate mortality is still high but appears correlated to associated lesions. Today's treatments must preserve autonomy for these patients. For elderly patients, the treatment must be chosen in relation to the fracture analysis. In our opinion, surgical management is the treatment of choice for unstable fractures (type II). Conservative management is indicated for stable fractures. PMID: 19643449 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - July 27, 2009 Category: Neurosurgery Authors: Lefranc M, Peltier J, Fichten A, Desenclos C, Toussaint P, Le Gars D Tags: Neurochirurgie Source Type: journals

[Isolated hypophyseal tuberculoma: Often mistaken.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hypophyseal tuberculoma is extremely rare and difficult to diagnose without a clearly suggestive context. Its radiologic features are not specific and are better recognized on MRI with a mass of a variable signal related to the percentage of caseous necrosis. A frequently associated thickening of the pituitary stalk suggests tuberculosis, requiring the search for another tuberculosis location. This paper reports an original case of hypophyseal tuberculoma since it occurred with no other tubercular infection, which delayed the diagnosis despite thickening of the pituitary stalk on MRI. PMID: 19615704 [PubMed - as su...
Source: Neuro-Chirurgie - July 14, 2009 Category: Neurosurgery Authors: Salem R, Khochtali I, Jellali MA, Zrig A, Maatouk M, Jazerli N, Kriaa S, Affi T, Hafsa C, Kacem M, Golli M Tags: Neurochirurgie Source Type: journals

[Severe orthostatic hypotension and intramedullary tumor: A case report and review of the literature.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report an interesting case of severe OH that had complicated the surgical treatment of a high cervical spinal cord ependymoma and we review the literature. PMID: 19592056 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - July 7, 2009 Category: Neurosurgery Authors: Derrey S, Maltête D, Ahtoy P, Fregey P, Proust F Tags: Neurochirurgie Source Type: journals

[Polyostotic fibrous dysplasia of the thoracic spine. A case study and review of the literature.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the case of a 46-year-old woman admitted to the emergency department for subacute paraplegia. The spinal X-ray showed a spontaneous fracture at the T4-T5 level. The CT scan revealed a tumor infiltration of the vertebral body responsible for lysis. Spinal MRI confirmed the neoplasia also located in the epidural space with spinal cord compression. The patient underwent an emergency laminectomy associated with transpedicular screw fixation between the T2 and T6 levels. At 2 months, she had evolved to a normal gait. In the second session, a transthoracic approach was used for a bone-graft-assisted fusion procedure to...
Source: Neuro-Chirurgie - July 2, 2009 Category: Neurosurgery Authors: Slimane MO, Foulongne E, Derrey S, Fréger P, Proust F Tags: Neurochirurgie Source Type: journals

Tension pneumocephalus and rhinorrhea revealing spontaneous cerebrospinal fluid fistula of the anterior cranial base.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of spontaneous CSFF of the ethmoid cribriform plate presenting with rhinorrhea and tension pneumocephalus. We discuss the physiopathology, the radiological management, and the treatment of spontaneous CSF fistulas related to the anterior skull base. A 58-year-old woman was admitted to our institution for headaches with clear rhinorrhea persisting over several days. Antecedents were unremarkable. An episode of epistaxis three days before was reported. Clinical examination showed clear rhinorrhea, headaches, and anosmia. The CT scan showed voluminous epidural and subdural pneumocephalus with mass effect on b...
Source: Neuro-Chirurgie - May 31, 2009 Category: Neurosurgery Authors: Lefranc M, Peltier J, Demuynkc F, Bugnicourt JM, Desenclos C, Fichten A, Toussaint P, Le Gars D Tags: Neurochirurgie Source Type: journals

[Early epidural hematoma after CSF shunt for obstructive hydrocephalus]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present the first case of early epidural hematoma after CSF shunt probably caused by defective material. A 26-year-old man was treated for obstructive hydrocephalus associated with a tonsillar herniation, revealed by headaches and papillary edema. Ventriculoperitoneal shunt was preferred to endoscopic ventriculostomy. Three hours after the operation, the patient fell into a coma, developing a voluminous bifrontal epidural hematoma that was evacuated immediately. The patient completely recovered neurologically. One month later, to treat persistent hydrocephalus, endoscopic ventriculostomy was performed without incident. ...
Source: Neuro-Chirurgie - May 31, 2009 Category: Neurosurgery Authors: Chauvet D, Sichez JP, Boch AL Tags: Neurochirurgie Source Type: journals

[Follicular dural lymphoma. Case report]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A case of a meningeal B-cell lymphoma is described. A 48-year-old man presented with an episode of grand mal seizure following a brain injury. An initial diagnosis of extradural hematoma was made based on the results of the cerebral computerized tomography scan. Magnetic resonance images demonstrated an enhanced mass with a dural tail attached to the meningeal layer of the temporal bone, suggesting a meningioma "en plaque". The mass was surgically excised. Tumoral removal was subcomplete (Simpson 2). Operative inspection also suggested a meningioma, but histological analysis and electron microscopy revealed a grade IV ...
Source: Neuro-Chirurgie - May 31, 2009 Category: Neurosurgery Authors: Peltier J, Fichten A, Lefranc M, Toussaint P, Desenclos C, Pruvot AS, Nicot B, Le Gars D Tags: Neurochirurgie Source Type: journals

[Multilevel contiguous injuries of the lower cervical spine during flexion trauma with delayed diagnosis: A case report.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The authors report a case of bilateral C4-C5 facet fracture dislocation associated with a severe sprain underlying C5-C6, which had occurred during an traffic accident. The diagnosis of severe sprain was raised on the 55thday. The injury mechanism is studied. Contiguous multilevel injuries of the lower cervical spine should be suspected in case of high-energy trauma. MRI can provide an exhaustif diagnosis of possible multilevel injuries. After fixation of the obvious lesion, intraoperative dynamic fluoroscopy must be performed to demonstrate any instability in another area. PMID: 19481230 [PubMed - as supplied by p...
Source: Neuro-Chirurgie - May 26, 2009 Category: Neurosurgery Authors: Uzel AP, Do L Tags: Neurochirurgie Source Type: journals

[Surgical management of solitary eosinophilic granuloma of the calvaria. Two case reports.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present two cases of calvarial eosinophilic granulomas that were surgically removed. These tumors are reputed to have an excellent prognosis, even if local recurrences and systemic dissemination can occur during the follow-up. The authors discuss the pathogenesis and the evolutive profile but also the therapeutic management of solitary eosinophilic granuloma of the calvaria. PMID: 19467681 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - May 18, 2009 Category: Neurosurgery Authors: Berhouma M, Krichen W, Chamseddine A, Jemel H Tags: Neurochirurgie Source Type: journals

[Central neurocytoma: Case report.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this study, we report one case of central neurocytoma treated in our department. It is a benign tumor of the lateral ventricles of the brain with neuronal differentiation. The clinical symptoms mainly consisted in intracranial hypertension syndrome. Immunohistochemical studies are necessary for the histopathological diagnosis. The treatment of choice is surgical. To guarantee good progression, complete ablation is necessary. The clinical progression, radiological aspects, treatment, histopathology, and postoperative progression will be discussed. PMID: 19447451 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - May 14, 2009 Category: Neurosurgery Authors: Bouaziz M, Mansour A, Feknous S, Yassi F, Smati S, Belhouchet S, Lankar A Tags: Neurochirurgie Source Type: journals

[Intraorbital dermoid cyst: Case report.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Dermoid cysts account for 3-4% of primary orbital tumors. The intraorbital location is relatively rare. The authors report a case of a 12-year-old male with an intraorbital dermoid cyst revealed by progressive right proptosis. The imaging aspects (CT scan and MRI) were consistent with intraconic dermoid cyst. The tumor was extirpated via a subfrontal approach. Histopathologic examination confirmed the diagnosis of dermoid cyst. The authors discuss the clinical symptoms, radiological aspects, and management. PMID: 19368946 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - April 12, 2009 Category: Neurosurgery Authors: Taha S, Doe K, Compeyre S, Nogues L, Lopes M, Leriche B Tags: Neurochirurgie Source Type: journals

Solitary fibrous tumor of the thoracic spine.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present a histologically and immunohistochemically confirmed solitary fibrous tumor involving the intradural extramedullary compartment of the thoracic spine. Microsurgical gross-total resection was achieved. A definitive role for adjuvant treatments in this type of tumor has not been established and therefore, they were not used. The patient was well, without clinical or radiological recurrence, 18months after surgery. PMID: 19356775 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - April 5, 2009 Category: Neurosurgery Authors: Arantes M, Honavar M, Vaz AR, Resende M, Pereira JR Tags: Neurochirurgie Source Type: journals

[Radiosurgery in trigeminal neuralgia: long-term results and influence of operative nuances]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Stereotactic radiosurgery is an alternative to conventional surgery for the treatment of trigeminal neuralgia. To better define the safety of radiosurgery and optimal technical choices, we reviewed our patient records and the literature. A total of 334 patients presenting with trigeminal neuralgia were treated between December 1992 and September 2005. A minimum of 1 year of follow-up was available for 262 patients. The mean age was 68 years (range: 30-90); 128 patients were male and 134 female. A neurovascular conflict was clearly visualized on MRI in 167 patients. Twenty-one had a past history of multiple sclerosis an...
Source: Neuro-Chirurgie - March 31, 2009 Category: Neurosurgery Authors: Regis J, Arkha Y, Yomo S, Murata N, Roussel P, Donnet A, Peragut JC Tags: Neurochirurgie Source Type: journals

[Neurosurgical treatment of primary hemifacial spasm with microvascular decompression.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In nearly all cases, primary hemifacial spasm is related to arterial compression of the facial nerve in the root exit zone at the brainstem. The offending arterial loops originate from the posterior inferior cerebellar, anterior inferior cerebellar, or vertebrobasilar artery. In as many as 40% of the patients, neurovascular conflicts are multiple. The cross-compression at the brainstem is almost always seen on magnetic resonance imaging combined with magnetic resonance angiography. Botulinum toxin can be useful by alleviating the symptoms, but the effects are inconstant and only transient. The definitive conservative t...
Source: Neuro-Chirurgie - March 27, 2009 Category: Neurosurgery Authors: Sindou M, Keravel Y Tags: Neurochirurgie Source Type: journals

[Treatment of trigeminal neuralgia with microvascular decompression.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Pure microvascular decompression (MVD) can cure (that is, no pain, no medication) primary trigeminal neuralgia (TN) caused by vascular compression in 75% of patients (90% when compression is pronounced), according to a Kaplan-Meier survival study at 15 years. MRI with high resolution evidences neurovascular conflicts with good reliability. The results were found to be significantly better when the prosthesis implanted to maintain the compressive vessel away was not touching the nerve. This argues in favor of a real decompressive mechanism of the MVD procedure, rather than a conduction block. Because pure MVD generally ...
Source: Neuro-Chirurgie - March 27, 2009 Category: Neurosurgery Authors: Sindou M, Leston JM, Le Guerinel C, Keravel Y Tags: Neurochirurgie Source Type: journals

[Vascular decompression as treatment of essential arterial hypertension.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article presents a literature review. Further clinical controlled studies have to be conducted to define precise indications. PMID: 19328498 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - March 26, 2009 Category: Neurosurgery Authors: Keravel Y, Sindou M Tags: Neurochirurgie Source Type: journals

[Functional neurosurgery in the cranial nerves hyperactivity syndromes: Conclusions.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions.] Neurochirurgie. 2009 Mar 26; Authors: Sindou M, Keravel Y PMID: 19328499 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - March 26, 2009 Category: Neurosurgery Authors: Sindou M, Keravel Y Tags: Neurochirurgie Source Type: journals

[Morphological anatomy of the cranial nerves of the cisternal segment (III-XII).]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
One hundred brains (first injected in cerebral arteries and veins with latex neoprene or India ink and studied under optic magnification) illustrate this anatomic chapter concerning the microsurgical anatomy of the cisternal segment, the neurovascular relationships, and the blood supply of the IIIrd to the XIIth cranial nerves. PMID: 19328500 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - March 26, 2009 Category: Neurosurgery Authors: Mercier P, Brassier G, Fournier HD, Delion M, Papon X, Lasjaunias P Tags: Neurochirurgie Source Type: journals

[Structural anatomy of cranial nerves (V, VII, VIII, IX, X).]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study reports a review of the literature on the structural anatomy of the Vth, VIIth, VIIIth, IXth, and Xth cranial nerves, known to harbor dysfunction syndromes in humans. Because these dysfunctions are hypothesized to be caused by neurovascular conflicts at the root entry/exit zone and the transitional zone between central and peripheral myelinization, this investigation focused on the study and description of this junction. All the cranial nerves, except the optic and olfactory nerves, which are considered to be more a direct expansion of the central nervous system, have a transitional zone between central myelin (...
Source: Neuro-Chirurgie - March 26, 2009 Category: Neurosurgery Authors: Guclu B, Meyronet D, Simon E, Streichenberger N, Sindou M, Mertens P Tags: Neurochirurgie Source Type: journals

[Foreword.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19328502 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - March 26, 2009 Category: Neurosurgery Authors: Sindou M, Keravel Y Tags: Neurochirurgie Source Type: journals

[Clinical aspects of trigeminal neuralgia.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Primary trigeminal neuralgia, termed "classical" in the international nomenclature, is an epilepsy-like disease. Diagnosis is easy when the disorder typical in presentation, based on clinical features and responsiveness to anticonvulsants. However, diagnosis can be difficult when atypical and/or in the long-duration forms. Furthermore, trigeminal neuralgia - even if typical in its clinical aspects - may be caused by a specific lesion and reveal a pathology. In other words, it may be symptomatic (secondary). Imaging, especially MRI, is of prime importance in identifying the cause and guiding the appropriate treatment. ...
Source: Neuro-Chirurgie - March 26, 2009 Category: Neurosurgery Authors: Laurent B, Keravel Y, Sindou M Tags: Neurochirurgie Source Type: journals

[Cranial nerve functional neurosurgery: Evaluation.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the results of an investigation carried out on the activity of functional neurosurgery of the cranial nerves in the French-speaking countries, based on the analysis of a questionnaire addressed to all the members of the SNCLF. Eighteen centers responded to this questionnaire, which showed that activities and indications varied greatly from one unit to another. The results appear homogeneous and comparable with those reported in the literature. The questionnaire sought to provide a global perspective, open to the comments and questions of all responders on the various techniques raised, with the objective of estab...
Source: Neuro-Chirurgie - March 26, 2009 Category: Neurosurgery Authors: Le Guérinel C, Sindou M, Auque J, Blondet E, Brassier G, Chazal J, Cuny E, Devaux B, Fontaine D, Finiels PJ, Fuentes JM, D'Haens J, Massager N, Mercier P, Mooij J, Nuti C, Rousseaux P, Serrie A, Stecken J, de Waele L, Keravel Y Tags: Neurochirurgie Source Type: journals

[Algorithms for neurosurgical treatment of trigeminal neuralgia.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Surgery should be considered only after anticonvulsant medications have failed or if medical treatment is not well-tolerated, including in cases of asthenia or drowsiness. In most reference centers, consensus is that MVD is the first option when patients are in good health. Percutaneous lesioning operations or radiosurgery are preferable in patients with adverse co-morbidity or those who are not willing to undergo open surgery. PMID: 19328505 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - March 26, 2009 Category: Neurosurgery Authors: Sindou M, Keravel Y Tags: Neurochirurgie Source Type: journals

[Microsurgical anatomy of the transoval percutaneous route to the trigeminal cave and the trigeminal ganglion.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The percutaneous Hartel transoval route goes through an inverted pyramid, with an inferior summit and a superior base that includes three compartments. The danger of the inferior compartment is the parotid duct. The middle compartment contains many branches of the mandibular nerve. The superior compartment is crossed by the internal maxillary artery and its branches, as well as the auditory tube. The base of the pyramid presents not only the foramen ovale, but also the foramen lacerum, where the trocar may injure the internal carotid, and the foramen jugulare, where the trocar may meet the internal jugular vein and ner...
Source: Neuro-Chirurgie - March 25, 2009 Category: Neurosurgery Authors: Alvernia J, Wydh E, Simon E, Sindou M, Mertens P Tags: Neurochirurgie Source Type: journals

[Treatment of trigeminal neuropathic pain by motor cortex stimulation.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The neurosurgical procedures currently available for the treatment of trigeminal neuralgia can induce trigeminal neuropathic pain. Severe forms of trigeminal neuropathic pain correspond to the classical facial anesthesia dolorosa, whose treatment is known to be very difficult. Chronic stimulation of the ventral posterolateral nucleus (VPL) of the thalamus was, in the past, the only neurosurgical therapy available to treat this complication. The long-term results have been disappointing, which opened the field to the development of other techniques, including stimulation of the motor cortex for which there is now suffic...
Source: Neuro-Chirurgie - March 25, 2009 Category: Neurosurgery Authors: Nguyen JP, Lefaucheur JP, Raoul S, Roualdes V, Péréon Y, Keravel Y Tags: Neurochirurgie Source Type: journals

[Functional anatomy of the cochlear nerve and the central auditory system.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The auditory pathways are a system of afferent fibers (through the cochlear nerve) and efferent fibers (through the vestibular nerve), which are not limited to a simple information transmitting system but create a veritable integration of the sound stimulus at the different levels, by analyzing its three fundamental elements: frequency (pitch), intensity, and spatial localization of the sound source. From the cochlea to the primary auditory cortex, the auditory fibers are organized anatomically in relation to the characteristic frequency of the sound signal that they transmit (tonotopy). Coding the intensity of the sou...
Source: Neuro-Chirurgie - March 20, 2009 Category: Neurosurgery Authors: Simon E, Perrot X, Mertens P Tags: Neurochirurgie Source Type: journals

[Functional anatomy of the glossopharyngeal, vagus, accessory and hypoglossal cranial nerves.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The glossopharyngeal nerve and the vagus nerve are mixed nerves containing sensory, gustatory, motor and autonomous fibers (parasympathetic). The glossopharyngeal nerve has mainly visceral afferent fibers from the tongue and pharynx, gustatory fibers from the posterior third of the tongue, parasympathetic afferent fibers from carotid sinus and carotid glomus, parasympathetic efferent fibers for the parotid gland and motor fibers for the muscles of the pharynx. The vagus nerve contains mostly visceral afferent fibers from laryngeal, intrathoracic and abdominal organs, parasympathetic efferent fibers for these intrathora...
Source: Neuro-Chirurgie - March 20, 2009 Category: Neurosurgery Authors: Simon E, Mertens P Tags: Neurochirurgie Source Type: journals

[Functional anatomy of trigeminal nerve.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The cranial nerve (CN) V is a mixed nerve that consists primarily of sensory neurons. It exits the brain on the lateral surface of the pons, entering the trigeminal ganglion within a few millimeters. Three major branches emerge from the trigeminal ganglion. The first division (V1, the ophthalmic nerve) exits the cranium through the superior orbital fissure, entering the orbit to innervate the globe and skin in the area above the eye and forehead. The second division (V2, the maxillary nerve) exits through a round hole, the foramen rotundum, into a space posterior to the orbit, the pterygopalatine fossa. It then re-ente...
Source: Neuro-Chirurgie - March 19, 2009 Category: Neurosurgery Authors: Leston JM Tags: Neurochirurgie Source Type: journals

[Tinnitus treatment: Neurosurgical management.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Tinnitus is a very frequent symptom affecting 10% of the general population. It corresponds to the perception of an internal noise that can severely impair the quality of life. Tinnitus management requires a multidisciplinary approach in which neuromodulation and neurosurgery tend to play major roles. Classification of tinnitus separates objective tinnitus (i.e., tinnitus that can be heard or recorded) from the more frequent subjective tinnitus (i.e., tinnitus only perceived by the patient). Objective tinnitus is either pulsatile synchronous with heartbeat or asynchronous. In the former, appropriate radiological testin...
Source: Neuro-Chirurgie - March 19, 2009 Category: Neurosurgery Authors: Londero A, Chays A Tags: Neurochirurgie Source Type: journals

[Imaging anatomy of cranial nerves.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Knowledge of the anatomy of the cranial nerves is mandatory for optimal radiological exploration and interpretation of the images in normal and pathological conditions. CT is the method of choice for the study of the skull base and its foramina. MRI explores the cranial nerves and their vascular relationships precisely. Because of their small size, it is essential to obtain images with high spatial resolution. The MRI sequences optimize contrast between nerves and surrounding structures (cerebrospinal fluid, fat, bone structures and vessels). This chapter discusses the radiological anatomy of the cranial nerves. PM...
Source: Neuro-Chirurgie - March 18, 2009 Category: Neurosurgery Authors: Hermier M, Leal PR, Salaris SF, Froment JC, Sindou M Tags: Neurochirurgie Source Type: journals

[Treatment of trigeminal neuralgia with thermorhizotomy.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Percutaneous radiofrequency (RF) thermorhizotomy of the trigeminal nerve is an effective treatment for trigeminal neuralgia. Long-term efficacy is proportional to the degree of postoperative hypoesthesia. The advantage is the topographic selectivity of the thermolesion, provided the electrode tip is placed accurately. This requires precise x-ray guidance and neurophysiological testing. In addition to the indication in idiopathic trigeminal neuralgia, especially for elderly patients with precarious conditions, thermorhizotomy is particularly useful for treating patients with trigeminal neuralgia due to multiple sclerosi...
Source: Neuro-Chirurgie - March 18, 2009 Category: Neurosurgery Authors: Sindou M, Tatli M Tags: Neurochirurgie Source Type: journals

[Vertigo treatment correlated to their mechanisms.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Vertigo is an illusion of rotatory or linear movement that demonstrates a functional or lesional disturbance of the vestibular system, from periphery to central connections. According to the ANAES report (1997), benign paroxysmal positional vertical vertigo, vestibular neuronitis and Ménière's disease account for 40-50% of all mixed vertigo etiologies. Central etiologies may account for 20-40% of causes and 10-40% remain more difficult to classify, and are usually classified under the term of "peripheral vestibulopathy." These include vertigo due to neurovascular compression syndrome of the VIIIth nerve. Clin...
Source: Neuro-Chirurgie - March 18, 2009 Category: Neurosurgery Authors: Tilikete C, Vighetto A Tags: Neurochirurgie Source Type: journals

[Treatment of trigeminal neuralgia with glycerol injection at the gasserian ganglion.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Gasserian ganglion neurolysis with glycerol injected percutaneously through the foramen ovale continues to be widely used. Its long-term efficacy on pain is proportional to the degree of postoperative hypoesthesia. The advantage is low cost. The disadvantage is essentially the difficulty in controlling diffusion outside the Meckel cavity. Subsequently its effects are somewhat random and potential complications are difficult to prevent reliably. PMID: 19303116 [PubMed - as supplied by publisher] (Source: Neuro-Chirurgie)
Source: Neuro-Chirurgie - March 18, 2009 Category: Neurosurgery Authors: Sindou M, Tatli M Tags: Neurochirurgie Source Type: journals

[Surgery for vertigo.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Spontaneous recovery or central compensation makes surgical procedures rare in patients with vertigo. Surgery for vertigo proposed after pharmacological or physical therapy fails to eliminate Ménière's disease and some very rare cases of paroxystic positional vertigo. The main target in treating Ménière's disease is to promote vestibular compensation, which is possible only with a nonprogressive and stable deficit leading to readjustment of vestibular reflexes. Surgical procedures can be classified as nondestructive (endolymphatic sac decompression, vestibular nerve decompression, patching of perily...
Source: Neuro-Chirurgie - March 18, 2009 Category: Neurosurgery Authors: Lacombe H Tags: Neurochirurgie Source Type: journals