RESUMO
The authors report their surgical experience with 10 cases of anterior subcutaneous ulnar nerve transposition and coverage of the nerve with substitutive dural flap, performed between January and November 2008 at the Department of Neurosurgery ("Santa Maria alle Scotte" Hospital, Siena, Italy) in the treatment of severe cubital tunnel syndrome. Clinical long-term results are analyzed and the relevant literature is reviewed.
Assuntos
Síndrome do Túnel Ulnar/cirurgia , Nervo Ulnar , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/métodos , Próteses e Implantes , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Patients with intracranial anterior circulation aneurysms are subjected to surgical operation because of rupturing of the sac of the aneurysm leading to spontaneous subarachnoid hemorrhage (which occurs in most of the cases) or because of the neurological complaints caused by the mass or pulsation effect of the aneurysms against the surrounding brain structures. Direct surgical treatment of these giant aneurysms is always a challenging procedure but it makes feasible both the clipping of the neck of the aneurysm and the reduction of its mass effect. METHODS: A case series of 47 giant anterior circulation aneurysms, operated during a time span of 23 years (1972-1994) in our Institution is presented. RESULTS: In 31 cases the occlusion of the neck of the aneurysm could be achieved by applying single or multiple clips; in the remaining 16 cases the occlusion of the aneurysm was obtained by the aid of different methods. The operative mortality was 12.7%. CONCLUSIONS: Endovascular techniques for giant aneurysms occlusion are extremely useful in a combined approach. Due to their low morbidity these treatments can achieve a major role although some long term follow-up studies are still needed for a better understanding of their role.
Assuntos
Aneurisma Intracraniano/diagnóstico , Aneurisma Intracraniano/cirurgia , Adolescente , Adulto , Idoso , Embolização Terapêutica , Humanos , Aneurisma Intracraniano/mortalidade , Complicações Intraoperatórias , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neurocirurgia/métodos , Tomografia Computadorizada por Raios XRESUMO
An alternative technique for performing minimally invasive release of carpal tunnel syndrome is described. The suggested methodology is based on transillumination of the carpal tunnel during surgery. The advantages of the technique are discussed and compared with other available surgical procedures including endoscopy. The authors also describe preliminary operative results in 50 consecutive patients.
