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Objective: The rate of intracranial haemorrhage (ICH) after deep brain stimulation ranges between 1.5 and 6.1% with permanent deficits detected in 0.4 to 2.53% of cases. Preventive steps must be introduced to avoid this serious complication. Therefore we assessed the use of preoperative platelet[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: The need for using multiple trajectories and intraoperative testing in an awake patient during DBS for Parkinson’s disease is discussed controversially. In our department it was done in all cases. We aimed to find out if there is a benefit for such a procedure in the clinical outcome.[for full text, please go to the a.m. URL], 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Objective: Low or empty battery status of non-rechargeable deep brain stimulation impulse generators (IG) requires a surgical IG exchange several years after initial implantation. Complications in patients undergoing DBS surgery are reported in the range between 7,6 % up to 25,3 %. The aim[for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Objective: Deep brain stimulation is an established treatment in movement disorders. Movement disorders following brain lesions are rare and deep brain stimulation in these cases is always an individual decision. To reassess results of our surgical indications we compiled our cases. Our department realized[for full text, please go to the a.m. URL], 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Einleitung: Die cMRT (craniale Magnetresonanztomographie) ist eine sensitive und etablierte Methode ohne das Risiko einer Strahlenexposition. Bisher ist es in der Primärdiagnostik beim kindlichen Schädel-Hirn-Trauma (SHT) nicht etabliert. Diese retrospektive Studie untersucht den Nutzen und[zum vollständigen Text gelangen Sie über die oben angegebene URL], 133. Kongress der Deutschen Gesellschaft für Chirurgie

Objective: Deep brain stimulation (DBS) is a widely employed therapeutic modality for the neurosurgical treatment of movement disorders. This study focuses on the subjective patient perception of this specific procedure. Method: Via comprehensive postal structured interviews, patients were asked [for full text, please go to the a.m. URL], 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Objective: Lesions of the clivus may be challenging in terms of diagnosis and treatment. The differential diagnosis includes chordoma, chondrosarcoma, osteosarcoma, osteoblastoma, multiple myeloma, fibrous dysplasia, eosinophilic granuloma, aneurysmal bone cysts, meningioma and bone metastasis. We present[for full text, please go to the a.m. URL], 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Objective: Neuroendoscopic techniques have advanced significantly during the past decade. Endoscopic treatment of hydrocephalus is also technically possible and, somewhat promising, in small children. However, more data is needed to adequately apply these techniques to patients. The goal of endoscopy[for full text, please go to the a.m. URL], 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Objective: The World Health Organization (WHO) „Surgical Safety Checklist“ (SSC) is recommended for operating theatres since 2009 in order to improve communication and therefore reducing mistakes. The checklist contains simple-to-answer details of the patient and operating team identity,[for full text, please go to the a.m. URL], 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Objective: Intradural disc herniation is a rare condition. An incidence of intradural disc herniation in between 0,26 -0,30% of all herniated discs has been reported. Only 3% of all intradural disc herniation are found in the cervical region. Adhesion between dura sac and posterior longitudinal[for full text, please go to the a.m. URL], 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

The utility of magnetic resonance angiography is sometimes limited in the diagnostic workup of cerebral aneurysms with low flow and/or partial thrombosis when weighed against digital subtraction angiography. We present the case of a rare superior cerebellar artery giant, partially thrombosed aneurysm in which additional i.v. contrast-enhanced MRA sequences were comparable to digital subtraction angiography. It demonstrated not only the exact spatial resolution and correct anatomical relation but also the hemodynamics which were confirmed by intraoperative Doppler ultrasound. This report supports the feasibility and utility of i.v. contrast-enhanced MRA for posterior fossa giant cerebral aneurysm management.

Objective: Symptomatic movement disorders, especially when conventionally difficult to treat, have an influence on the spine due to a constant, and sometimes even increasing alteration of its physiological alignment. The aim of our study was to show whether there is a correlation between the coincidence[for full text, please go to the a.m. URL], 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Pharmacological thrombolysis is a valuable therapeutic modality for embolic arterial occlusion. Nevertheless, thorough evaluation of the indications is imperative to avoid serious complications. The most frequent complication is hemorrhage. Of these, the intracerebral hemorrhages are rare, but when they do occur they are an immediate threat to life they are accompanied by very severe complications, and they have an extremely poor prognosis. Within 58 months 361 patients were treated at our neurosurgical clinic with intracerebral hematomas. In 22 patients (6.1%) the hematoma developed as a complication of systemic thrombolysis. Two of these patients had been treated for occlusion of the central retinal artery. One patient died: the other survived but was severely disabled. The latter patient experienced no benefit from the thrombolysis as for as the underlying ophthalmologic disease was concerned. These worrying examples stress the necessity for careful evaluation of risk factors and the natural history of the underlying disease for which systemic thrombolysis is indicated. Local selective (or superselective) thrombolysis is preferable to the systemic procedure, provided that the indications are equally strictly observed and are less likely to lead to severe complications.

ZusammenfassungDie Therapie mit Antikoagulanzien und Thrombolytika ist unter strenger Indikationsstellung ein bewährtes Behandlungskonzept. Die häufigste Komplikation ist die Blutung. Dabei gehören intrakranielle Blutungen zu den seltenen, jedoch aus prognostischer Sicht zu den ernsthafteren, vital bedrohlichen Komplikationen. Unter 283 Patienten mit einem spontanen intrazerebralen Hämatom fanden sich 42 Patienten (14,8%), bei denen die Blutung unter einer gerinnungshemmenden Therapie aufgetreten war. Bei 24 Patienten (8,5%) war es unter einer Phenpro-coumon-Behandlung, bei 18 Patienten (6,3%) nach einer Thrombolysetherapie zur Blutung gekommen. Risikofaktoren wie Alter über 70 Jahre (n = 15), Hyper-tonus (n = 25), Diabetes mellitus (n = 3), Medikamenteninteraktionen (n = 11), Zustand nach stattgehabter intrazerebraler Blutung (n = 3) wurden analysiert. Insgesamt 26 Patienten wurden operativ, 16 Patienten konservativ behandelt. Die zerebral bedingte Letalität betrug 42,8%, in der Marcumar®-Gruppe 41,6%, in der Thrombolyse-Gruppe 44,4%. Die Indikation zur oralen Antikoagulation sollte sorgfältig gestellt und im Laufe der Behandlung wiederholt überprüft werden, um die Behandlungsdauer auf den absolut erforderlichen Zeitraum zu beschränken. Der sorgfältigen Beachtung von Medikamenteninteraktionen, akuter interkurrenter Erkrankungen sowie der Dynamik der mit zunehmendem Alter häufig vergesellschafteten Multimorbidität kommt besondere Bedeutung zu.

Objective: Awake glioma surgery is used for resection of brain tumors adjacent to eloquent brain areas (speech or motor cortex). The aim of surgery is to maximize the extent of resection and minimize postoperative neurological deficits. Therefore, intraoperative high-field MRI combined with neuronavigation[for full text, please go to the a.m. URL], 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Objective: Despite optimal neurosurgical care for patients undergoing DBS and excellent clinical results, a number of complications need to be dealt with. Therefore the identification of risk factors and especially prone patient groups is essential. Methods: We retrospectively analyzed risk factors[for full text, please go to the a.m. URL], 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Objective: Measurement of regional cerebral oxygen saturation (rSO2) with near infrared spectroscopy (NIRS) is used frequently during cardiac and vascular surgeries. However, continuous measurement for detecting cerebral vasospasm (CVS) after SAH is not done consistently. The aim of our prospective [for full text, please go to the a.m. URL], 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Objective: The aim of this study was to present the data of a large cohort of patients with spontaneous supratentorial intracerebral hemorrhage (ICH), who were treated in our department and give a current overview considering special clinical characteristics, performed therapy and different predictive[for full text, please go to the a.m. URL], 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Objective: Camptocormia is a rare syndrome, which is defined as an abnormal flexion of the thoracolumbal spine that appears in the upright position and increases during walking. It occurs in Parkinson's disease or Dystonia or it can appear as a primary idiopathic disease. In the literature, data[for full text, please go to the a.m. URL], 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Objective: The primary central nervous system lymphoma (PCSNL), as one of the uncommon extranodal lymphomas, has been recently paid more attention especially for its increasing incidence, unsatisfactory therapy and poor prognosis. MGMT is one of the most important factors for determining drug resistance[for full text, please go to the a.m. URL], 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Objective: SUNCT-syndrome is a rare pain syndrome. It presents with short-term unilateral neuralgiform headache attacks with conjuntival injection, tearing, sweating and rhinorrhea. Due to failure of non-invasive medical therapies, single cases of deep brain stimulation are described with conflicting[for full text, please go to the a.m. URL], 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Objective: Subarachnoid hemorrhage (SAH) of unknown origin can be differentiated into perimesencephalic (PM-SAH) and non-perimesencephalic SAH (NON-PM-SAH), where PM-SAH has clearly defined radiological features. We analyzed the data of 179 patients with SAH of unknown origin and present special features[for full text, please go to the a.m. URL], 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Objective: Involvement in neuro-modulatory processes makes the endogenous cannabinoid/chemokine system a potential key element in cascades underlying central neuropathic pain development after SCI. Therefore, detailed expression profiles of chemokines, their receptors and cannabinoid CB1 receptor[for full text, please go to the a.m. URL], 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010

Objective: Quality management has the potential to significantly improve patient pathways in medical institutions. However, it also requires significant personal resources. The aim of this project was to evaluate our quality management system in terms of resources, structure and benefit for the clinical[for full text, please go to the a.m. URL], 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010

Introduction: The co-existence of tumors of the nervous system (CNS) and symptomatic hydrocephalus is frequent and can cause severe clinical problems, although, the issue is underestimated in the literature. Materials and methods: We have reviewed our database on cases with CNS tumors and symptomatic[for full text, please go to the a.m. URL], 127. Kongress der Deutschen Gesellschaft für Chirurgie

Objective: Glioblastoma is the most frequent and most malignant primary brain tumor in adults. It is regarded as the endpoint of diffusely infiltration gliomas. Its molecular profile is regarded heterogenous. However, systematic information on this issue is sparse. The aim of this study was to quantify[for full text, please go to the a.m. URL], 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010

Introduction: Metastasis to the brain and bone is a major source of morbidity and mortality in cancer patients. We report genetic profiling of brain- and bone-selective invasive and metastatic MDA-MB-231 breast cancer cells using cDNA Array technology and real-time RT-PCR. Materials and methods: [for full text, please go to the a.m. URL], 127. Kongress der Deutschen Gesellschaft für Chirurgie

Patients suffering subarachnoid hemorrhage in whom angiography does not initially show vascular malformation and CT scan rules out an intracranial tumor, have, reportedly, a good prognosis with a rate of recurrent hemorrhage of about 2-10% within a follow-up time of up to 15 years. Most authors denied indication for control angiography. In order to study the benefit of control angiography performed after 4-6 weeks, four-hundred eighty-three patients with SAH but without ICH were reveiwed, and the longterm clinical course of 98 patients with SAH of unknown origin treated in our department between 1976 and 1988 was investigated. Among 183 patients who underwent control angiography, a second angiography showed an aneurysm in 143. The third angiography was positive in a further 18 patients. Recurrent SAH occurred early only in patients who had undergone only one angiography. One patient died from intracerebral hemorrhage of unknown origin two years following SAH. These data support the need for control angiography in cases of SAH.

Objective: To further investigate mechanisms underlying central neuropathic pain after spinal cord injury (SCI), we established the expression profiles of cannabinoid CB1 receptor immunoreactivity on spinal and supra-spinal levels after experimental SCI. Methods: Spinal cord impact lesions (100kdyn,[for full text, please go to the a.m. URL], 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien

Objective: There is evidence that defective DNA mismatch repair (MMR) results in tolerance to temozolomide regardless of O(6)-alkylguanine-DNA alkyltransferase (AGT) activity. Dysfunction of MMR genes, in particular MLH1, MSH2, and MSH6, leads to loss of MMR protein expression and to microsatellite [for full text, please go to the a.m. URL], 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien

Objective: Local chemotherapy with gliadel® has been increasingly used in the last years. A study by Giese et al. with 11 patients receiving the actual BCNU wafers had shown no difference of recurrence patterns in local and systemic chemotherapy. It also made no difference in total or subtotallyresected[for full text, please go to the a.m. URL], 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien