The Israel Medical Association journal: IMAJ 08/2010; 12(8):509-10. · 0.90 Impact Factor
Acta Neuropathologica 09/2009; 118(4):579-81. · 9.78 Impact Factor
Neurosurgery 10/2008; 63(3):N4. · 3.03 Impact Factor
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ABSTRACT: To present results of early angiographic diagnosis and endovascular treatment of traumatic intracranial aneurysms (TICA).
From June 2002 to December 2006, diagnostic angiography was performed on patients with moderate to severe traumatic brain injury that involved a cranial base fracture or a penetrating brain injury with a tract from the penetrating agent that entered at the pterional area, went through the middle cerebral artery candelabra, and crossed the midline. TICAs were treated by various endovascular techniques during the same angiographic procedure.
Thirty-four patients with traumatic brain injury underwent angiography (25 penetrating brain injuries, nine blunt injuries); 13 TICAs were diagnosed (10 penetrating brain injuries, three blunt injuries). The Glasgow Coma Scale score at diagnosis ranged from 5 to 15. Angiography was performed for screening in eight patients and for clinical indications in five patients; 11 TICAs were diagnosed before rupture. Seven aneurysms were located on branches of the middle cerebral artery, two on pericallosal branches of the anterior cerebral artery, and four on the internal carotid artery. No recanalization was detected in 12 patients. One patient treated with a bare stent and coiling had a growing intracavernous pseudoaneurysm; therefore, internal carotid artery occlusion with extracranial-intracranial microvascular bypass was performed. Six patients refused angiographic follow-up, but computed tomographic angiography has failed to show recanalization. No patient presented with delayed bleeding (mean follow-up, 2.6 yr). There were no procedure-related complications or mortality.
Early angiographic diagnosis with immediate endovascular treatment provided an effective approach for TICA detection and management. Endovascular therapy is versatile and offers a valuable alternative to surgery, allowing early aneurysm exclusion with excellent results.
Neurosurgery 10/2008; 63(3):476-85; discussion 485-6. · 3.03 Impact Factor
Skull Base Surgery 01/2007; 17. · 0.60 Impact Factor
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ABSTRACT: We evaluate a new technique for plateless fixation of a bone flap after fronto-orbital craniotomy.
From September 1999 to October 2004, we performed fronto-orbital craniotomy reconstruction using the Craniofix titanium clamp in 108 consecutive patients with a variety of lesions in the anterior skull base. Postoperative computed tomographic imaging studies and clinical evaluations were performed to prospectively assess cosmetic conformity and bone flap stability and to evaluate the surgical benefit of Craniofix in these patients.
Excellent bone flap fixation and cosmetic results were obtained in all patients 6 to 68 months (average, 36 months) after surgery.
The Craniofix titanium clamp is a reliable, safe, and simple fixation device for reconstruction of fronto-orbital craniotomy.
Surgical Neurology 02/2006; 65(1):51-4. · 1.67 Impact Factor