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Iatrogenic dural arteriovenous fistula and aneurysmal subarachnoid hemorrhage

Sudhakar Vadivelu, Xin Xin, Tina Loven, Guillermo Restrepo, David J. Chalif, and Avi Setton

Venous Drainage Treatment Nabors et al., 1987 2 cases of MVD for trigeminal neuralgia or muscle blood vessels to dura mater 1) rt OA & MMA; 2) OA, ascending PhA, & MMA rt sigmoid sinus; jugular vein embo w/ PVA particles in both cases Pappas et al., 1992 subdural hematoma direct trauma to dural vessels AMA parallel vein coagulation of dural vessels & resection of dura involved by fistula Sasaki et al., 1995 trigeminal neuroma postop thrombus formation in sinus—fistulous dev after apposition of muscle blood vessels to dura lt OA

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Percutaneous trigeminal tractotomy–nucleotomy with use of intraoperative computed tomography and general anesthesia: report of 2 cases

Eric M. Thompson, Kim J. Burchiel, and Ahmed M. Raslan

A lthough not commonly used, tractotomy-nucleotomy is a viable treatment option for patients with malignancy-related facial pain, neuropathic facial pain, postherpetic neuralgia, glossopharyngeal neuralgia, geniculate neuralgia, and refractory trigeminal neuralgia. 3 , 5 Postherpetic neuralgia is an especially severe and difficult pain syndrome to treat and is occasionally associated with facial allodynia and hyperalgesia. Tractotomy has a durable success rate of greater than 80%. 3 , 5 The procedure is typically performed with CT guidance in an awake

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Dural relationships of Meckel cave and lateral wall of the cavernous sinus

Rashid M. Janjua, Ossama Al-Mefty, Duane W. Densler, and Christopher B. Shields

clarified to be a posterior fossa dura evagination into the middle fossa. Burr and Robinson 7 used carbon particles to examine the extent of the MC and demonstrated the cave to extend “much farther distally on the posterior surface of the ganglion … when it was lifted from its bed.” Dandy (1938) described complications of alcohol spillage into the MC and subsequently the posterior fossa following injections into the GG for trigeminal neuralgia. Ferner 14 , 15 investigated the anatomy of the trigeminal nerve and outlined the MC in microscopic detail. He observed the

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Radiosurgery for glomus jugulare: history and recent progress

Zachary D. Guss, Sachin Batra, Gordon Li, Steven D. Chang, Andrew T. Parsa, Daniele Rigamonti, Lawrence Kleinberg, and Michael Lim

palsy, tinnitus, hearing loss, and otalgia. Permanent symptoms were hearing loss and trigeminal neuralgia. Several studies reported that there was no association between radiation dose and clinical outcome, 48 tumor control, 13 , 48 or toxicity. 22 , 37 The latter stands in contrast to the study published by Miller et al., 30 which concluded that the most significant risk factor for developing trigeminal neuropathy after radiosurgery for vestibular schwannomas is the radiation dose. This group recommends doses < 16 Gy and notes that doses > 18 Gy were the

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Contemporary methods of radiosurgery treatment with the Novalis linear accelerator system

Joseph C. T. Chen, Javad Rahimian, Michael R. Girvigian, and Michael J. Miller

removed from the patient's head. Dry dressings are placed, and the patient is discharged home. Typical treatment times range from ~ 1 hour for trigeminal neuralgia indications to < 20 minutes per lesion for most other lesions. Fractionated stereotactic radiotherapy, which typically ranges from 3 to 30 fractions, has been applied in the treatment of selected lesions. Such lesions are typically too large for single-fraction radiosurgery or are in contact with a special sensory nerve, such as the optic nerve, and have limited single-fraction dose tolerance. To accomplish

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Surgical management of trigeminal schwannomas

Ricardo Ramina, Tobias A. Mattei, Marília G. Sória, Erasmo B. da Silva Jr., André G. Leal, Maurício C. Neto, and Yvens B. Fernandes

or more trigeminal branches. Intensity may vary from light to lancinating pain. It may occur in paroxysms, usually without trigger zones, or may last hours. According to Day and Fukushima, 7 the majority of patients with TSs have paroxysmal lancinating facial pain in episodes that tend to last longer than classic trigeminal neuralgia and do not respond to carbamazepine. Some authors 8 , 28 , 32 , 43 reported that trigeminal pain may be absent with tumors originating distally in the divisions, whereas it is more common in tumors arising from the ganglion. Other

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Retrosigmoid approach for resection of petrous apex meningioma

Daniel G. de Souza, Leo F. S. Ditzel Filho, Girma Makonnen, Matteo Zoli, Cristian Naudy, Jun Muto, and Daniel M. Prevedello

We present the case of a 50-year-old female with a 1-year history of right-side facial numbness, as well as an electric shock-like sensation on the right-side of the face and tongue. She was previously diagnosed with vertigo and trigeminal neuralgia. MRI was obtained showing a large right cerebellopontine angle mass. A retrosigmoid approach was performed and total removal was achieved after dissection of tumor from brainstem and cranial nerves IV, V, VI, VII and VIII. Pathology confirmed the diagnosis of a meningioma (WHO Grade I). The patient was discharged neurologically intact on the third postoperative day free of complications.

The video can be found here: http://youtu.be/-tR0FtMiUDg.

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German military neurosurgery at home and abroad

Uwe Max Mauer, Chris Schulz, Ronny Rothe, and Ulrich Kunz

grafting and ventral plate fixation. The ISAF members with thoracic and lumbar spine injuries underwent only dorsal instrumentation and decompression. Definitive ventral treatment was provided by a hospital in the home country. Afghan patients also received ventral treatment involving the placement of interposition grafts (iliac crest bone grafts, rib grafts, or spineoplasty) in the field hospital. Local patients also underwent elective surgical procedures for disc herniation, trigeminal neuralgia, entrapment neuropathy, and other conditions. Until October 2009, no

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Bulgarian military neurosurgery: from Warsaw Pact to the North Atlantic Treaty Organization

Yavor Enchev and Tihomir Eftimov

endovascular embolization of brain and spinal vascular malformations and aneurysms ( Fig. 4 ), as well as with endovascular stenting procedures, has been gained. F ig . 4. Endovascular treatment of cerebral brain aneurysm. A: Preembolization angiographic study. B: Postembolization angiographic study. The applied functional neurosurgical procedures are epileptic surgery, glycerol rhizolysis, microvascular decompression, and rhizotomy in cases of trigeminal neuralgia, cancer pain surgery, and so on. All possible neuroendoscopic procedures, such as third

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Effect of previous botulinum neurotoxin treatment on microvascular decompression for hemifacial spasm

Xuhui Wang, Parthasarathy D. Thirumala, Aalap Shah, Paul Gardner, Miguel Habeych, Donald J. Crammond, Jeffrey Balzer, and Michael Horowitz

SP : Long-term efficacy of botulinum a toxin for blepharospasm and hemifacial spasm . Can J Neurol Sci 37 : 631 – 636 , 2010 10.1017/S0317167100010817 12 Habeych ME , Shah AC , Nikonow TN , Balzer JR , Crammond DJ , Thirumala PD , : Effect of botulinum neurotoxin treatment in the lateral spread monitoring of microvascular decompression for hemifacial spasm . Muscle Nerve 44 : 518 – 524 , 2011 10.1002/mus.22104 13 Jannetta PJ : Outcome after microvascular decompression for typical trigeminal neuralgia, hemifacial spasm, tinnitus