Biomedical subjects

Borimir J Darakchiev

Publications and source records attributed to Borimir J Darakchiev.

3 recordsLinked to original sources

PubMed2005

Adaptation of a standard low-field (0.3-T) system to the operating room: focus on pituitary adenomas.

iMRI is a reliable and safe tool to monitor the extent of resection and to avoid complications in the transsphenoidal surgical approach for pituitary tumors. The best indication for its application in transsphenoidal surgery is for patients with pituitary macroadenomas with suprasellar extension. The low-field 0.3-T magnet has a diagnostic imaging quality that provides surgeons with good intraoperative detail of the anatomic relations in the sellar region. In our experience, iMRI provided a distinct benefit in planned STR for invasive macroadenomas that compress the optic chiasm and in planned GTR for noninvasive tumors. The iMRI design adopted at our center includes important features, such as the use of ferromagnetic surgical instruments, elimination of patient transportation, and capability as a shared resource, that allow multipurpose diagnostic use and increased cost-effectiveness.

Adenoma↗

PubMed2004

Cerebrospinal fluid dynamics in skull base surgery.

PURPOSE OF REVIEW: This review examines disturbances of cerebrospinal fluid (CSF) dynamics after skull base surgical and endoscopic approaches. Despite the continuing advancements and the effectiveness of skull base surgery, the incidence of postoperative rhinorrhea remains problematic. This adverse event carries a significant potential for major neurologic insult related to infection of the central nervous system. RECENT FINDINGS: The contemporary literature provides excellent reports that summarize the management of this important clinical entity focusing on particular aspects of its diagnosis and treatment. Advances in various imaging technologies have enabled the accurate localization of CSF fistulas. However, their complexity requires physicians to have significant knowledge about the advantages and limitations of each test. SUMMARY: Patients with CSF leaks are often referred to otolaryngologists to undergo transnasal endoscopic treatment. When CSF leaks are severe, recurrent, or not amenable to endoscopic treatment (previous posterior fossa or transpetrosal approach), the treatment choice is open repair through craniotomy.

Brain Diseases↗

PubMedDate not supplied

Stereotactic radiosurgery for patients with solid brain metastases: current status.

The goal of this article is to provide a contemporary update on the use of stereotactic radiosurgery (SRS) for the treatment of intracranial metastatic disease. We discuss the rationale for employing SRS in brain metastases and describe the critical factors that predict outcome. We highlight the main clinical indications for SRS including treatment of recurrent brain metastases after previous whole brain radiation therapy (WBRT), as a boost after WBRT, and as sole therapy for newly diagnosed tumors. For each clinical scenario, we offer a treatment algorithm based on our clinical experience. The article also addresses the most common complications associated with SRS and their treatment.

Brain Neoplasms↗