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Familial Haemangiomata of the Cerebellum

Report of Three Cases in a Family of Four

Henrik O. Tonning, Rupert F. Warren and Howard J. Barrie

.G. McKenzie disclosed a very vascular tumour in the lower half of the left cerebellar hemisphere causing direct pressure on the medulla. It was the size of a large walnut. A large venous channel, ⅛″ in diameter, ran from the tumour and into the transverse sinus. Several large thin-walled veins communicated with this main vessel. Puncture of the left cerebellar hemisphere showed that the tumour was firm, solid, and unusually vascular. Decompression only was attempted. Course . Following operation she received an intensive course of x-ray therapy and was discharged after 65

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Etiology and definitive microsurgical treatment of hemifacial spasm

Operative techniques and results in 47 patients

Peter J. Jannetta, Munir Abbasy, Joseph C. Maroon, Francisco M. Ramos and Maurice S. Albin

by peripheral myelin. Why the vascular cross-compression must be located precisely at this point we do not know. We can only conjecture that the junction zone defects may predispose to disordered conduction when this part of the nerve is cross-compressed by a blood vessel. Mild facial weakness is common in hemifacial spasm of long duration, especially if the tonus phenomenon is present. Strength improves gradually after vascular decompression, and is frequently improved in the recovery room. Experience with the surgical binocular microscope and a thorough

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Ranjit K. Laha and Peter J. Jannetta

cranial nerves at the nerve root entry zone. With the aid of the operating microscope under × 16 to ×25 magnification, the vessels were mobilized away from the nerve and a polyvinyl chloride sponge * was interposed between the nerve and the vessel. In the remaining patient a tortuous vertebral artery was seen cross-compressing the rootlets of the ninth and tenth cranial nerves, and the vessel was not disturbed for fear of causing infarction of the brain stem. In Case 6, in addition to vascular decompression of the ninth and tenth, the fifth cranial nerve was also

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Richard A. Roski, Samuel J. Horwitz and Robert F. Spetzler

potential testing were entirely within normal limits. Operation . A posterior fossa vascular decompression procedure was performed by one of us (R.S.). The procedure was done through a small retromastoid suboccipital craniectomy with the child in the sitting position. The petrosal vein was ligated and cut. A branch of the vein arising 1 mm lateral from its brainstem origin pierced the fifth nerve and clearly grooved it. The loop of vein was coagulated and removed from the nerve. The remainder of the nerve was explored, and no other vascular compression was noted except

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Microvascular decompression for trigeminal neuralgia

Results with special reference to the late recurrence rate

Robert Breeze and Ronald J. Ignelzi

51 consecutive patients who underwent 52 microsurgical vascular decompression procedures of the trigeminal nerve (Jannetta procedure) at the University of California, San Diego, (UCSD) Medical Center during the years 1976 to 1980. Each patient presented with the symptomatology of typical trigeminal neuralgia. Surgery was performed by one of four neurosurgeons at the UCSD Medical Center. Follow-up data were obtained on all patients sufficient for the variable analysis of this study. The follow-up period ranged from 1 to 53 months. Follow-up information was

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A 10-year experience in the treatment of trigeminal neuralgia

Comparison of percutaneous stereotaxic rhizotomy and posterior fossa exploration

Harry van Loveren, John M. Tew Jr., Jeffrey T. Keller and Mary A. Nurre

Neurosurgical Techniques. New York: Grune and Stratton (In press) 56. Waga S , Morikawa A , Kojima T : Trigeminal neuralgia: compression of the trigeminal nerve by an elongated and dilated basilar artery. Surg Neurol 11 : 13 – 16 , 1979 Waga S, Morikawa A, Kojima T: Trigeminal neuralgia: compression of the trigeminal nerve by an elongated and dilated basilar artery. Surg Neurol 11: 13–16, 1979 57. Wilson CB , Yorke C , Prioleau G : Microsurgical vascular decompression for trigeminal neuralgia and

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Toshio Matsushima, Albert L. Rhoton Jr., Evandro de Oliveira and David Peace

22. Jamieson KG : Excision of pineal tumors. J Neurosurg 35 : 550 – 553 , 1971 Jamieson KG: Excision of pineal tumors. J Neurosurg 35: 550–553, 1971 23. Jannetta PJ : Vascular decompression in trigeminal neuralgia , in Samii M , Jannetta PJ (eds): The Cranial Nerves: Anatomy-Pathology-Diagnosis-Treatment. Berlin/Heidelberg/New York : Springer-Verlag , 1981 , pp 331 – 340 Jannetta PJ: Vascular decompression in trigeminal neuralgia, in Samii M, Jannetta PJ (eds): The Cranial

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John P. Latchaw Jr., Russell W. Hardy Jr., Sarah B. Forsythe and Allan F. Cook

occurred 5 or more years prior to RC ( Fig. 1 ). During this time, many had been treated by other modalities, as listed in Table 1 . Fig. 1. Time of onset of symptoms before first radiofrequency coagulation (RC). TABLE 1 Treatment modalities used prior to radiofrequency coagulation Treatment No. of Cases acupuncture 3 dental procedures 20 alcohol nerve block 19 infraorbital nerve section 6 temporal craniotomy and neurolysis 19 suboccipital craniectomy & vascular decompression 2

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David Barba and John F. Alksne

procedure has been reported to be in the range of 80% to 90%. 1, 2, 6 We obtained similar results in our primary decompression patients. However, in those patients undergoing microvascular decompression after an unsuccessful prior rhizotomy procedure, we achieved relief in less than half the cases even though vascular abnormalities were identified and corrected at the time of surgery. It is possible that this difference in outcome is due to selection for the prior procedure: that is, only patients who did not respond to the prior surgery required vascular decompression

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Elizabeth A. M. Frost

craniectomy in the sitting position for nerve decompression, the right atrial catheter was omitted. 64 Although air was detected by Doppler ultrasound in 35% of cases, with prompt therapy (flooding the operative field, application of positive end-expiratory pressure and jugular venous compression) no postoperative neurological deficits were recorded. The authors concluded that, in the particular surgical circumstance described (vascular decompression), right atrial catheterization was not justified because it offered no advantages and subjected the patients to unnecessary