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Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of this work was a retrospective evaluation of the safety of the supracerebellar transtentorial approach in our patient series. It represents a technically challenging approach, which we used during surgeries of the posterior and medial mediotemporal area, lateral mesencephalon and posteromedial thalamus. Materials and methods: We evaluate the series of our 8 patients, which we operated on using the supracerebellar transtentorial approach during 2013–2021. In one case, we dealt with anaplastic astrocytoma, 3× with glioblastoma multiforme primary surgery, 1× with diffuse midline H3K27M glioma, 1× with glioblastoma multiforme recurrence surgery, 1× with low-grade glioma surgery and once we operated using this approach an acutely bleeding cavernoma of the lemniscal trigone of the mesencephalon. All our patients were operated on in a semisitting position. Results: The thirty-day mortality rate of our series is zero. In case of a patient with diffuse midline H3K27M glioma which was primarily operated on in a bad neurological condition, we had to perform early revision surgery using the same approach due to residual tumor hemorrhage. In case of our first patient with extensive mediotemporal anaplastic astrocytoma, we had to add the suboccipital approach for resection radicality increase early after the first phase of surgery; after the surgery, he had superior quadrantanopsia. In one patient's case, ischemia of the occipital lobe occurred due to an intraoperatively visible lesion of the posterior cerebral artery inside the glioblastoma. After surgery, hemianopsia was present. Conclusion: The approach poses a technically challenging, but concurrently safe surgical trajectory. In case of the lesions affecting the mediotemporal area, it is advantageous for its medial and posterior part, but during the resection it is possible to reach as far as the uncus and amygdala. The prerequisite condition is accurate anatomical knowledge; in our department, we prefer the semisitting position for this approach. It is important to have a sufficient cerebrospinal fluid decompression by releasing the fluid from the cisterna magna from a separate dural incision and a gentle manipulation of the vascular structures of the tentorial incisura. [ABSTRACT FROM AUTHOR]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of our work was retrospective evaluation of the resection extent of predicted and ongoing low-grade glioma (LGG) surgeries. Furthermore, we evaluated the behavior of defined residual tumors after subsequent oncological treatment in case of partial and subtotal resections. Patients and methods: We evaluated a series of our 37 patients operated on during 2010–2019 at the Department of Neurosurgery, Masaryk Hospital in Ústí nad Labem. The anatomical eloquent boundary lines were strictly defined by the primary motor and visual cortex (g. precentralis and adjacent gyri to the calcarine sulcus), including their tracts, further pars triangularus and pars opercularis of the inferior frontal gyrus as expressive language areas and the structures of the central core. No absolute eloquent region was the perisylvian cortex of the dominant hemisphere. A partial resection we defined as a presence of the tumor layer > 1 cm evaluated on T2 weighted MRI 2–4 months after surgery. Subtotal resection was defined identically as tumor layer less or equal to 1 cm. Results: As potentially possible radically resectable (YES), we evaluated an overall 25 patients (68%) in our series with: 1) six patients (16%) with a safe limit to the eloquent area (YES Safe) – in this instance we reached radical resection in all cases; 2) 19 patients (51%) with the necessity of reaching the border to the specific area (YES Risk) – in this instance we reached radical/subtotal/partial resection in 7/6/6 patients. As necessarily partially resectable (NO), we evaluated 12 patients (32%) and in this instance, we really reached partial resections in all cases. The residual tumor positively reacted to the oncological treatment in 90% of the cases, the shortest period of observation was 13 months. Major complication of the surgery occurred in one case of a female patient (2.7%). The other complications (5.4%) were mild – one case of hemianopsia and one case of a supplementary motor area lesion. Conclusion: The definition of anatomical boundaries of LGG and position of eloquent areas correspond with prediction of the extent of gained resection. However, alpha-omega of success is respecting brain arteries and veins in the surgical field. If a neurosurgeon approaches the margin of safety in an eloquent cortex and its tracts and leaves a small remnant of the tumor during the surgery, radiochemotherapy after surgery is indicated and is effective [ABSTRACT FROM AUTHOR]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Provedli jsme dalsí stimulacní test, následkem nehoz doslo k aktivaci detruzoru s charakteristickymi pulsy kontrakcí a pauz po stimulaci, po které následovalo vyprázdnení mocového mechyre ze 75 % (obr. Nasím cílem je vytvorit centrum pro implantaci Brindleyho stimulátoru a po jednání s pojistovnami získat prostredky k financování operací u indikovanych jedincu. Po peclivém komplexním vysetrení (MR pátere, urologické, interní a neurologické vysetrení) a rozvaze byl nemocny 4 roky po traumatu indikován k SDAF-SARS. [Extracted from the article]

Aim: Decompressive craniectomy is a method of choice in the treatment of malignant middle cerebral artery infarction. Based on the conclusions of the three European prospective trials DECIMAL, DESTINY and HAMLET and their pooled analysis, we performed a retrospective analysis for years 2014-2018 at our department to assess the clinical outcome of patients who underwent decompressive craniectomy for malignant middle cerebral artery infarction. Patients and methods: The set consisted of 33 patients. Results: 22 operated patients died as a result of the disease, three patients were grade 4 and four patients grade 3 on the modifi ed Rankin Scale. Four patients had to be excluded from the cohort. We monitored parameters such as the patient's age at time of stroke, the time that had elapsed since the clinical manifestation and since determination of diagnosis according to CT to the start of surgery and midline shift on CT. We performed a statistical analysis of the baseline data, but these were not entirely benefi cial for a probably small group of patients. Conclusion: In general, in line with the fi ndings of European studies, the patient's age at stroke onset (below 60 years) and the time elapsed from the clinical manifestation and from graphic signs of ischemia to the start of decompressive craniectomy (less than 48 h) are essential positive prognostic factors. [ABSTRACT FROM AUTHOR]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The authors present a monocentric retrospective study of a group of 27 patients operated for non-ruptured brain arteriovenous malformation (AVM) during years 1999-2017. The aim was to compare our results with the results of larger international studies and to draw appropriate conclusions. All patients underwent radical resection of the AVM and their clinical status was evaluated using the modifi ed Rankin scale before and after the surgery with an average 6-year follow-up. The group was represented by the AVM´s Spetzler-Martin Scale I-IV. After resection, six patients improved, one deteriorated, and the others remained in the same condition as before surgery. Our morbidity was 3.7 % and mortality was 0 %. After 16 years of follow-up, no recurrence or residual malformation were detected in any patient. Compared to foreign studies, our results for all types of AVM´s are comparable and, therefore, for the unruptured the AVM´s Spetzler-Martin I-II microsurgical approach, for the unruptured AVM´s Spetzler-Martin III microsurgical approach with possible complementary alternatives of embolization or radiotherapy and for the AVM´s Spetzler- Martin IV-V rather observation can be recommended. [ABSTRACT FROM AUTHOR]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The presented case report describes the first use of adenosine-induced transient circulatory arrest in a patient undergoing cerebral aneurysm clipping in the Czech Republic. Short episodes of circulatory arrest improved surgical conditions (as assessed by the surgeon) without any apparent complications during surgery. The cumulative length of circulatory arrest was 47 seconds; the total dose of administered adenosine was 90 mg. The postoperative course was uneventful and the patient was discharged home with a good functional status. Current scientific evidence in this field and key practical points of this technique are discussed. [ABSTRACT FROM AUTHOR]

Aim of the study: Purpose of this study is to evaluate peripheral nerve (PN) regeneration after microsurgical reconstruction in our series of PN injuries in children, to identify the best surgical technique and its timing and to describe the post-operative care and the follow-up schedule. The pitfalls and the alternate management if the primary surgical reconstruction fails are provided. Material and methods: We retrospectively evaluated a series of children treated at our institution between 1999 and 2012. In this 14-year period 67 lesions in 60 patients (45 males, 15 females) were identified. Mean age was 12.3 years. 44 injuries constituted the completely transected PN, 20 partially and 3 lesions were concluded as traction injuries. The median nerve was the most frequently severed, followed by the ulnar nerve, typically at the wrist/distal forearm. The most common cause was a fall through the glass door. 48 lesions (80%) were treated immediately, 7 (12%) in a delayed fashion and 5 (8%) late. Direct microsuture was performed in 54 (81%) lesions; exoneurolysis in 6 (9%); and the autograft interposition was used in 7 lesions (10%). Results: 26 children with 31 lesions completed 2-year follow-up period, 26 lesions in this subgroup (84%) recovered successfully (defined as motor function ≥M4 and sensory ≥S3 per B.M.R.C.). 5 (16%) recovered unsatisfactorily and in 4 of them we performed a secondary tendon transfer with good functional outcome. Conclusion: Peripheral nerves in children show remarkable regeneration capabilities and an immediate repair yields very good outcome. We advocate that the nerve repair should be performed in a timely manner to prevent more complicated reconstruction procedures with worse functional outcome. [ABSTRACT FROM AUTHOR]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Anterior choroidal artery aneurysms (AChoAA) belong to less frequent cerebrovascular lesions and therefore there are still only a few reports describing their neurosurgical management. We decided to share our experience and present two unusual cases of AChoAA we have treated in our department. We also report one of the first published use of the Yasargil T-bar fenestrated clip for solving of a AChoAA. Methods: We present two cases of unruptured AChoAA treated in 2016 with respect to patient's history, radiological and microsurgical anatomy of the aneurysm, surgical procedure and clinical follow-up. Results: Both aneurysms were successfully treated with surgical clipping. In case 1 we used a single T-bar fenestrated clip. To our best knowledge this might be the first reported use of such clip in treatment of AChoAA. In case 2 for a large AChoAA a standard straight Aesculap clip was used. Both procedures were performed with microvascular Doppler sonography and under electrophysiological monitoring with motor-evoked potentials (MEP). Temporary disturbance in MEP signal during surgery was observed in the T-bar clip case and led to reposition of the clip. Both patients had a good surgical outcome without any clinical or radiological signs of ischemia in the AChoA or any other territory. Conclusion: As previous literature we confirm that surgical treatment of AChoAA is a good and safe alternative to endovascular treatment. We propose, using T-bar fenestrated clip might be appropriate solution for treatment of these lesions. We also suggest that combination of monitoring methods (MVDS, ICG and MEP monitoring) during AChoAA surgery is a very valuable way for prevention of ischemic infarction in the AChoA territory. [ABSTRACT FROM AUTHOR]