Biomedical subjects

L Lustgarten

Publications and source records attributed to L Lustgarten.

3 recordsLinked to original sources

PubMed2002

How safe is twistdrill craniostomy?

The incidence of haemorrhagic complications of intracranial pressure monitoring (ICPM) has previously been reported. However, in these studies, the techniques employed to access the inside of the cranium varied. While 3-mm essentially blind 'twistdrill' craniostomies have been used, their role has been limited for fear of haemorrhagic sequelae. This has also restricted their use in clinical applications other than ICPM. We conducted a prospective observational study looking at haemorrhagic complications of the twistdrill in order to determine its safety and whether it has a role in other clinical settings. Over the period January 1994-February 2001, 941 patients had 1032 twistdrill procedures. There were 550 (58.4%) male patients and 391 (41.6%) female. The age range was 3 months to 93 years (median age 35 years). Only four procedures (0.38%) caused clinically significant bleeds attributable to the twistdrill --all of which were managed conservatively without requiring surgical evacuation. We conclude that twistdrill craniostomies are safe and that their use could be extended to other neurosurgical procedures and potentially to ICPM in non-neurosurgical centres.

Adolescent↗

PubMed1999

Paediatric intracranial aneurysms: results of a surgical series and literature review of Guglielmi detachable coil embolization.

It is known that the profile of aneursyms in the paediatric age group demonstrates a different biology and epidemiology than those in the adult population in terms of size, sex, location, multiplicity and complications such as vasospasm and rebleeding. As a consequence of their different behaviour, timing of surgery does not appear to be such a critical issue in their management decision. Surgical clipping is still the treatment of choice, however, with our growing experience of endovascular techniques, these might prove to be a suitable alternative in the future. We report the results of our surgical series of 17 paediatric and adolescent patients harbouring 18 arterial intracranial aneurysms (age range 7-18 years). Systemic diseases traditionally known to be associated with this entity were excluded. In order to assess endovascular techniques as a potential treatment alternative for this group of patients, we reviewed the current literature, dealing with Guglielmi detachable coil (GDC) embolization of arterial cerebral aneurysms in this age group. No current series deals purely with paediatric aneurysms; we have reviewed paediatric cases reported as part of large adult series. Copyright 1999 Harcourt Publishers Ltd.

Journal Article↗

PubMed1997

Benign intracerebral cysts with ependymal lining: pathological and radiological features.

Cerebral intraparenchymal cysts without communication with the ventricles are very rare. We report four such cases with no relevant past history or evidence of infection, haemorrhage, trauma, tumour or congenital neural tube defect. At operation smooth wailed cysts with an ependymal-type lining were found. To the best of our knowledge, we present the first correlation of their pathological and radiological features (including magnetic resonance imaging). We also review the literature on these cysts.

Adult↗