The application of n-butyl 2-cyanoacrylate to repair CSF fistulas for 221 patients who underwent transsphenoidal surgery.

Background: The adequate repair of intraoperative CSF leaks during transsphenoidal surgery remains a challenge. The authors describe the application of N-butyl 2-cyanoacrylate (cyanoacrylate) tissue glue for repair of CSF fistulas during transsphenoidal surgery.

Methods: The authors retrospectively reviewed the records of 221 consecutive patients who underwent transsphenoidal surgery during 1998-2007.

Esmail Jorjani (1042-1137) and his descriptions of trigeminal neuralgia, hemifacial spasm, and bell's palsy.

Esmail Jorjani was a prominent Persian physician of the 11th and 12th centuries. We present Jorjani's descriptions of probable trigeminal neuralgia, hemifacial spasm, and Bell's palsy. Additionally, on the basis of our translations of his original text, we believe that Jorjani may have been the first to implicate an artery-nerve conflict as an etiology of trigeminal neuralgia.

Surgery for cervical dystonia: the emergence of denervation and myotomy techniques and the contributions of early surgeons at The Johns Hopkins Hospital.

Cervical dystonia is a psychologically and physically disabling disease that has intrigued clinicians since the early history of surgery. Because of its elusive etiology, its operative treatment has had an extended evolutionary voyage. Early surgical approaches involved resection of the sternocleidomastoid muscle.

Cushing's lost cases of "radium bomb" brachytherapy for gliomas.

Although recent efforts to advance the treatment of gliomas through radiotherapy and chemotherapy may seem to be a relatively new area of growth and development, these efforts have been in progress since the therapeutic potential of radiation therapy was discovered in the late 19th century. Cushing's use of brachytherapy has been mentioned several times in the literature without receiving an appropriate in-depth analysis. The reasoning behind Cushing's initial use of brachytherapy was not fully examined, and a close analysis of the outcomes of this therapy was not made.

Surgery for extratemporal nonlesional epilepsy in children: a meta-analysis.

Purpose: Previous small studies have demonstrated that seizure outcomes following surgery for extratemporal lobe epilepsy (ETLE) in children are worse than those for temporal lobe epilepsy. We have conducted a meta-analysis of the available literature to better understand ETLE surgical outcomes in children.

Methods: We searched PubMed (1990-2009) for appropriate studies using the following terms: ETLE, ETLE surgery, ETLE surgery outcome, frontal lobe epilepsy, occipital lobe epilepsy, and parietal lobe epilepsy.

Variant intraneural vein-trigeminal nerve relationships: an observation during microvascular decompression surgery for trigeminal neuralgia.

Objective: Trigeminal neuralgia is often caused by compression, demyelination, and injury of the trigeminal nerve root entry zone by an adjacent artery and/or vein. Previously described variations of the nerve-vessel relationship note external nerve compression. We offer a detailed classification of intraneural vessels that travel through the trigeminal nerve and safe, effective surgical management.

A unique experiment in neurological surgery: intracerebral injection of antitoxin for tetanus.

The discipline of neurological surgery was considered primarily "hopeless" and, at best, experimental in the late 19th century. Harvey Cushing's efforts during his initial uncharted voyage through the surgery of the human cranium were rudimentary and exploratory. A direct review of his available patient records from early in his career provides the opportunity to look back at Cushing as a physician-scientist, uncovering work that demonstrates that he was at the forefront of neurosurgical intervention in avenues that have been largely overlooked.

Johan Georg Raeder (1889-1959) and paratrigeminal sympathetic paresis.

Introduction: Johan Georg Raeder (1889-1959) was the most eminent Norwegian ophthalmologist in the early decades of the last century. Raeder made significant contributions to our current understanding of glaucoma. He is remembered for a syndrome he described, that of trigeminal nerve neuralgia and/or paresis and incomplete Horner's syndrome (oculopupillary sympathetic paresis).

Facial palsy and its management in the Kitab al-Hawi of Rhazes.

More than 1000 years ago, Rhazes practiced rudimentary neurology. This monumental physician wrote more than 200 books in his lifetime and died a blind pauper in the 10th century AD. His Kitab al-Hawi (Liber Continens) was one of the most famous and detailed medical texts of the ancient world.

Outcome of renal transplant in hereditary gelsolin amyloidosis.

Amyloid nephropathy is an unusual manifestation of hereditary gelsolin amyloidosis and may present with proteinuria and progressive renal failure. We report the first case of renal transplantation in a patient with hereditary gelsolin amyloidosis complicated by end-stage renal disease. The patient was a 44-year-old man from the Northwest of Iran who had undergone hemodialysis for 1 year.

Neurosurgical management of intracranial lesions in the pregnant patient: a 36-year institutional experience and review of the literature.

Object: A review of the literature has revealed scant data related to neurosurgical treatment of gravid patients. The authors reviewed their experience with the neurosurgical treatment of pregnant women to better characterize the optimal management strategies for intracranial pathological entities in this population.

Methods: Between July 1969 and July 2005, 34 patients with documented pregnancy and concomitant intracranial pathological entities were treated at the authors' institution.

Conquering the third ventricular chamber.

Surgery within the third ventricle was a special challenge early in the conception of the discipline of neurosurgery due to a lack of diagnostic methods and difficulty in reaching and removing lesions affecting this vital region. Walter Dandy and Harvey Cushing performed pioneering approaches of the third ventricular region. The authors have reviewed the previously undisclosed efforts of Cushing to approach the third ventricle through a direct review of his available patient records at the Cushing Brain Tumor Registry.

Vasovagal syncope in the Canon of Avicenna: the first mention of carotid artery hypersensitivity.

Ibn Sina, known as Avicenna in the West, was a celebrated Persian thinker, philosopher, and physician who is remembered for his masterpiece, The Canon of Medicine. The Canon that served as an essential medical encyclopedia for scholars in the Islamic territories and Europe for almost a millennium consisted of 5 books. In the third book, Avicenna described patients with symptoms of carotid hypersensitivity syndrome.

Evolution of techniques for the resection of vestibular schwannomas: from saving life to saving function.

The current state of surgery for vestibular schwannomas (VSs) is the result of a century of step-by-step technical progress by groundbreaking surgeons who transformed the procedure from its hazardous infancy and high mortality rate to its current state of safety and low morbidity rate. Harvey Cushing advocated bilateral suboccipital decompression and developed the method of intracapsular tumor enucleation. Walter Dandy supported the unilateral suboccipital approach and developed the technique of gross-total tumor resection.