Journal of Neurosurgery Academy

Full Endoscopic Lumbar Discectomy Inter Laminar (FELD-IL) approach – a case report

Sukumar — Thu, 04 Apr 2024 00:00:00 +0000

Minimally invasive surgical techniques are becoming increasingly common in spinal surgery in an attempt to decrease tissue trauma during surgery, which in turn decreases post-operative pain. Full endoscopic lumbar discectomy inter laminar is being increasingly used because of its potential to minimalize soft-tissue damage and decrease hospital stay. FELD using the interlaminar approach (FELDIL) is performed by only a few surgeons. In this study we are going to discuss a case done on Full Endoscopic Lumbar Discectomy using Inter Laminar (FELD-IL) approach.

Endoscopic hemispherotomy: an illustrative video

Fri, 22 Mar 2024 00:00:00 +0000

Endoscopic surgery has brought about a paradigm shift in the field of neurosurgery. It provides a panoramic view, heightened illumination, magnification, and the unique ability to navigate corners, all of which significantly enhance surgical precision. Endoscopic hemispherotomy is a procedure that allows functional disconnection of the abnormal hemisphere from the ipsilateral basal ganglia, thalamus, and contralateral brain. This video article gives an overview of endoscopic hemispherotomy for a case of drug-refractory epilepsy due to an old middle cerebral artery infarct. It also showcases the value of functional magnetic resonance imaging in deciding the surgery.

Tailoring endoscopic third ventriculostomy for diverse 3rd ventricular floor landscapes

Ramesh Teegala — Wed, 27 Mar 2024 00:00:00 +0000

Endoscopic third ventriculostomy (ETV) offers an effective minimally invasive solution for obstructive hydrocephalus. This video chapter provides insights into patient selection, surgical technique, and post-operative care for ETV. The chapter outlines ETV’s evolution and indications, emphasizing meticulous patient selection based on radiological parameters and clinical evaluation. Pre-operative planning ensures procedural precision, with detailed guidance on optimal head positioning and burr hole placement. Under general anesthesia, the ETV technique involves precise ventricular access and stoma creation using channeled neuroendoscopes. Post[1]operative management focuses on vigilant monitoring and outcome assessment. ETV demonstrates success rates ranging from 70 to 90%, with proper patient selection and pre-operative evaluation associated with better outcomes. This chapter serves as a valuable resource for neurosurgeons navigating hydrocephalus, showcasing ETV’s efficacy in select cases.

Neurosurgical precision at its peak: deep brain stimulation - patient selection strategy and surgical technique – a video article

K. Visvanathan — Fri, 29 Mar 2024 00:00:00 +0000

Deep Brain Stimulation (DBS) has emerged as a promising therapeutic approach for various neurological disorders. This video article elucidates the intricacies of DBS surgery and patient selection criteria. The article comprehensively discusses the indications for DBS across diverse conditions including Parkinson’s disease, primary generalized dystonia, essential tremor, obsessive-compulsive disorder, Tourette’s syndrome, drug-resistant major depression, drug-resistant epilepsy, minimally conscious state, and certain addictive disorders. The article ensure optimal outcomes and patient safety. The surgical procedure is meticulously detailed, encompassing the pre-operative planning phase involving Magnetic Resonance Imaging (MRI) and stereotactic coordinates determination. The step-by-step surgical process is elucidated, from frame application and Computed Tomography (CT) fusion to electrode implantation and confirmation of placement. Post-operative management, including programming of the Implantable Pulse Generator (IPG) and addressing complications, is also discussed. By providing insights into the surgical nuances of DBS and patient selection criteria, this video article serves as a valuable resource for neurosurgeons and healthcare professionals involved in the management of neurological disorders amenable to DBS therapy.

STA – MCA bypass surgery

Venkatesan — Fri, 29 Mar 2024 00:00:00 +0000

Cerebral bypass surgery, such as the STA-MCA (superficial temporal artery to middle cerebral artery) bypass, is a critical procedure aimed at restoring blood flow to oxygen-deprived areas of the brain. This surgery involves rerouting blood from a donor vessel, typically the superficial temporal artery, to a recipient vessel within the brain, bypassing blockages or damaged arteries. Indications for this surgery include Moyamoya disease, aneurysms, skull base tumors, and arterial stenosis. Pre-operative imaging helps in planning the surgery, while post-operative care involves monitoring for complications like stroke and graft occlusion. Although bypass surgery improves blood supply, it does not cure underlying vascular diseases. Thus, patients are advised to adhere to medication regimens and adopt a healthy lifestyle for optimal long-term outcomes. Bypass surgery offers a vital intervention in managing cerebrovascular conditions, emphasizing the importance of multidisciplinary care and patient education.