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Meningiomas involving the optic canal: pattern of involvement and implications for surgical technique

Ahmed Nageeb M. Taha, Kadir Erkmen, Ian F. Dunn, Svetlana Pravdenkova, and Ossama Al-Mefty

, and 7 cases were recurrent tumors previously operated on elsewhere. Patients with optic canal decompression with no tumor inside the canal were excluded from the study. TABLE 1: Clinical characteristics of 45 patients with meningiomas * Characteristic Value sex (no.of pts)  M 14  F 31 age range 30–79 yrs (mean 51.6 yrs) follow-up range 6–108 mos (mean 29.8 mos) no. of pts w/ main presenting Sx  visual disturbances 37  headache 2  migraine 1  vertigo 1  epilepsy 2  trigeminal

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Evaluation of hearing function after Gamma Knife surgery of vestibular schwannomas

Alberto Franzin, Giorgio Spatola, Carlo Serra, Piero Picozzi, Marzia Medone, Davide Milani, Paola Castellazzi, and Pietro Mortini

significant differences (p = 0.762, Fisher exact test). Conservation of the Function of CNs V and VII The function of the trigeminal nerve was preserved in all the patients except for those 2 patients with hypesthesia and trigeminal neuralgia as initial symptoms. In these patients the preexisting symptoms persisted even after the treatment. None of the patients developed a facial nerve deficit. The 2 patients with facial weakness (House-Brackman Grade II) as an initial symptom experienced a regression of the deficit even though the tumor volume remained unchanged

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Surgical management of trigeminal schwannomas: defining the role for endoscopic endonasal approaches

Shaan M. Raza, Angela M. Donaldson, Alpesh Mehta, Apostolos J. Tsiouris, Vijay K. Anand, and Theodore H. Schwartz

of success from microsurgical removal have been favorable. Independent of location and surgical approach, gross-total resection rates as high as 82% have been reported. 21 Functional outcomes have varied depending on the existence of preoperative symptoms, tumor size, and location. In larger reported series, either permanent or transient postoperative deterioration in neurological function, including trigeminal neuropathy, abducens nerve palsy, and trigeminal neuralgia, is experienced. These functional outcomes could be related to the anatomical disadvantage that

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Time-driven activity-based costing: a driver for provider engagement in costing activities and redesign initiatives

Nancy McLaughlin, Michael A. Burke, Nisheeta P. Setlur, Douglas R. Niedzwiecki, Alan L. Kaplan, Christopher Saigal, Aman Mahajan, Neil A. Martin, and Robert S. Kaplan

resource uses for each activity during a patient's care. 13 All of these activities can then be added together to measure the total cost of an entire service or care episode. Under the mentorship of the Harvard Business School and in collaboration with local clinician sponsors, 2 teams at UCLA Health (UCLA) piloted the TDABC model in service lines that already had ongoing value-improvement and care-redesign projects. One team studied the microvascular compression syndrome (trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia) service line (neurosurgery

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National treatment trends, complications, and predictors of in-hospital charges for the surgical management of craniopharyngiomas in adults from 2007 to 2011

Hasan A. Zaidi, Kristina Chapple, and Andrew S. Little

, Vidal S , Piepgras DG : The spectrum of malignancy in craniopharyngioma . Am J Surg Pathol 31 : 1020 – 1028 , 2007 10.1097/PAS.0b013e31802d8a96 29 Rosenbaum BP , Kelly ML , Kshettry VR , Vadera S , Weil RJ : Practice patterns of in-hospital surgical treatment of trigeminal neuralgia from 1988 to 2010 . Clin Neurol Neurosurg 120 : 55 – 63 , 2014 10.1016/j.clineuro.2014.02.011 30 Schwartz TH : A role for centers of excellence in transsphenoidal surgery . World Neurosurg 80 : 270 – 271 , 2013 10.1016/j.wneu.2012.11.019 31 Tomita

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The history of brain retractors throughout the development of neurological surgery

Rachid Assina, Sebastian Rubino, Christina E. Sarris, Chirag D. Gandhi, and Charles J. Prestigiacomo

Principles and Practice , Dr. Frazier describes using his lighted retractor in surgeries of the trigeminal nerve ( Fig. 9A ). F ig . 9. A: Illustration of Dr. Frazier's lighted retractor to visualize the groove of the middle meningeal artery on the floor of the middle fossa, as described in his chapter, The Surgery of the Fifth (Trigeminal) Nerve . This illustration was printed in the 1922 surgical text, Surgery: Its Principles and Practice, Vol 8, by various authors. 30 B: Dr. Adson's use of an illuminated retractor in treatment of trigeminal neuralgia in

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Dual occipital and supraorbital nerve stimulation for chronic migraine: a single-center experience, review of literature, and surgical considerations

Shannon Hann and Ashwini Sharan

of SONS to treat cluster headaches and combined ONS and SONS for treatment of various trigeminal neuralgias and facial pain syndromes. 1 , 8 , 21 We report our institutional experience with 14 cases of CM that were treated with ONS and SONS in the hope of adding evidence to the growing knowledge of neuromodulation for primary headache treatment as well as adding neurosurgical perspective in techniques to prevent lead-related complications. Methods Patient Selection A review of 14 consecutive patients with CM who underwent combined ONS and SONS between

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Regional trends and the impact of various patient and hospital factors on outcomes and costs of hospitalization between academic and nonacademic centers after deep brain stimulation surgery for Parkinson's disease: a United States Nationwide Inpatient Sample analysis from 2006 to 2010

Mayur Sharma, Sudheer Ambekar, Bharat Guthikonda, Jessica Wilden, and Anil Nanda

stimulation (DBS) for PD in the last decade, lesional surgery has again fallen out of favor, and DBS has become the treatment of choice for refractory or advanced PD. Reversibility of side effects and the ability to treat bilaterally and to optimize the treatment during programming are the key advantages of DBS over lesioning. 14 , 20 Other indications of DBS are dystonia and tremor in movement disorders, depression, obsessive-compulsive disorder, and Tourette's syndrome in psychiatry, epilepsy, cluster headache, pain from stroke, amputation, trigeminal neuralgia, and

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Management of intracranial aneurysms associated with arteriovenous malformations

Bruno C. Flores, Daniel R. Klinger, Kim l. Rickert, Samuel l. Barnett, Babu G. Welch, Jonathan A. White, H. Hunt Batjer, and Duke S. Samson

ophthalmic artery feeders or significant ophthalmic vein draining pattern, trigeminal neuralgia, etc.). Despite this multitude of applications, the treating neurosurgeon should keep in mind the inherent risks associated with endovascular embolization of BAVMs. Our institution has previously published our 11-year results for preoperative embolization of these lesions. 75 In that series that involved 339 procedures performed in 201 patients, preoperative embolization was associated with a 1.2% mortality rate and a 6.5% permanent neurological deficit rate per procedure, or

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Neuronavigation: geneology, reality, and prospects

Yavor Enchev

and thalamus because of their definite and stable relationship to the third ventricle topography. In 1933, Kirschner 46 was the first surgeon to apply frame-based stereotaxy to human patients. He punctured the skull base's foramen ovale to treat idiopathic trigeminal neuralgia. The individual variations in the intracranial structures in humans as opposed to animals and the absence of imaging techniques to visualize these variations, however, limited the stereotactic calculation of deep brain targets. In 1947, the doctors Ernest Spiegel (a conservative Austrian