Virtual image navigation: a new method to control intraoperative bleeding in neuroendoscopic surgery. Technical note.

In this neuroendoscopic study the authors tested the newly developed "red-out module" of their visual navigation system that enables the neurosurgeon to achieve hemostasis if total visualization is lost due to hemorrhage ("red out") within the visual field. An optical position measurement system connected to the endoscope guarantees that digitized endoscopic images are coupled with the accurate endoscopic position. Computerized images are simultaneously stored with their respective position data, and this creates a virtual anatomical landscape.

Clinical utility of magnetic resonance angiography in the evaluation of aneurysms from a neurosurgical point of view.

The possibilities and limitations of MRA in the evaluation of intracranial aneurysms were investigated in this study. 54 patients, 30 with acute SAH were diagnosed using the three dimensional time-of-flight MRA in comparison with a conventional four vessel digital subtraction angiography prior to surgery. Furthermore, postoperative MRA was performed to assess clip placement and vessel patency and to search for innocent additional aneurysms in patients with emergency surgery due to intracerebral hemorrhage causing mass effect in whom preoperatively only the side of the lesion was investigated in DSA.

Surgical treatment of recurrent trigeminal neuralgia.

In this retrospective investigation 7 patients operated on for recurrent trigeminal neuralgia via a suboccipital enlarged burr hole trepanation were evaluated. The intraoperative findings indicate that neo-compressive effects due to foreign material used during prior surgery are more important than adhesions around the nerve. Furthermore, the results of recurrent operations are encouraging as 6 of the 7 patients were painfree without additional neurological deficits.