Jarosław Dzierżanowski

Dural metastases of prostate adenocarcinoma are an extremely rare complication and may mimic intracranial hematoma. Preoperatively diagnosis may be difficult due to similarities in symptoms and radiological appearance. We present a 65-year-old man admitted to the ED with a history of headache, nausea, vomiting, vertigo, diplopia, as well as numbnes...

Aim of the study: The aim of this study was to assess the diagnostic value of diffusion tensor imaging (DTI) in patients with symptoms of cervical myelopathy. Detailed goals included determining the diagnostic effectiveness of quantitative parameters, i.e. fractional anisotropy (FA) and apparent diffusion coefficient (ADC), in the diagnosis of cer...

Background: Microsurgical clipping is a viable option for managing high-riding basilar apex aneurysms (BAXs) using a transsylvian approach. Cutting the posterior communicating artery (PCoA) at the perforator-free zone provides sufficient exposure of BAX, although, it is not always safe. The aim was to qualitatively predict sectioning of the interfe...

Aim of study: We aimed to verify the value of computerised tomography angiography (CTA) on predicting the extent of anterior clinoidectomy that is optimal for particular carotid-ophthalmic aneurysms (COAs). Clinical rationale for study: The anterior clinoid process (ACP) often impedes the complex microsurgery of COA. Complete removal of the ACP ens...

Background: Diffusion tensor imaging (DTI) is the imaging technique used in vivo to visualize white matter pathways. The corticospinal tract (CST) belongs to one of the most often delineated tracts preoperatively, although, the optimal DTI method has not been established yet. Considering that various regions of interests (ROIs) could be selected,...

Percutaneous vertebroplasty is a treatment option in vertebral compression fractures (VCF). The aim of the study was to propose the mathematical calculation of the “optimum volume” of acrylic cement filling of the vertebral body, depending on the severity of a fracture. Two hundred computed tomography (CT) scans of vertebral columns in healthy adul...

In this study we hypothesized that the alleviation of neurological symptoms long after internal carotid artery (ICA) stenting may be related to sustained improvement of cerebral perfusion. Thirty-four subjects (F/M; 15/19) with >70% stenosis of a single internal carotid artery and neurological symptoms, who underwent a carotid artery stenting proce...

Objectives: We tested the hypothesis that computed tomography (CT) perfusion markers of cerebral microcirculation would improve 36 months after internal carotid artery stenting for symptomatic carotid stenosis while results obtained 6-8 weeks after the stenting procedure would yield a predictive value. Methods: We recruited consecutive eligible...

Introduction Standard craniotomy (SC) and burr hole craniostomy (BHC) are regarded as the standard approaches to chronic subdural haematoma (CSDH). Bedside twist drill craniostomy (TDC), performed at the patient’s bedside, was introduced as an alternative to the standard methods. However, clinical and radiological features of patients treated with...

Transpedicular stabilization is a frequently used spinal surgery for fractures, degenerative changes, or neoplastic processes. Improper screw fixation may cause substantial vascular or neurological complications. This study seeks to define detailed morphometric measurements of the pedicle (height, width, and surface area) in the aspects of screw le...

Background: The estimated prevalence of unruptured intracranial aneurysms is 3%. Standard monitoring does not enable one to assess the influence of anaesthetics on the factors determining intracranial homeostasis. Thanks to transcranial Doppler ultrasonography, middle cerebral artery flow velocity (VMCA), reflecting cerebral blood flow, can be mea...

The aim of this study was to assess regional perfusion at baseline and regional cerebrovascular resistance (CVR) to delayed acetazolamide challenge in subjects with chronic carotid artery stenosis.Sixteen patients (ten males) aged 70.94±7.71 with carotid artery stenosis ≥90% on the ipsilateral side and ≤50% on the contralateral side were enrolled i...

Olfactory neuroblastoma (ONB) is a malignant neuroendocrine neoplasm with a usually slow course, but with considerable recurrence rate. Many neuroendocrine tumors have shown good response to the treatment with somatostatin analogues and somatostatin radioreceptor therapy. In ONBs, there are scarce data on somatostatin-based treatment and the cellul...

The aim of this study was to assess regional perfusion at baseline and regional cerebrovascular resistance (CVR) to delayed acetazolamide challenge in subjects with chronic carotid artery stenosis. Sixteen patients (ten males) aged 70.94±7.71 with carotid artery stenosis ≥ 90% on the ipsilateral side and ≤ 50% on the contralateral side were enrolle...

Background: Frontal aslant tract (FAT) is a white matter bundle connecting the pre-supplementary motor area (pre-SMA) and the supplementary motor area (SMA) with the inferior frontal gyrus (IFG). The purpose of the present study was to evaluate the anatomical variability of FAT. Materials and methods: Total number of fibres and the lateralisatio...

Background: The aim of this study was to analyse the morphometry of the intracranial segment of the vertebral artery in the context of clinical usefulness. The results were compared with published data available in full-text archived medical journals. Materials and methods: More than 100 DSA (digital subtraction angiography) and 3D angio-CT (com...

Olfactory neuroblastoma (ONB) is a rare neoplasm of the sinonasal area with neuroendocrine differentiation. ISL-1, TTF-1 and PAX5 are transcription factors that are frequently upregulated in tumors showing neuroendocrine differentiation. The aim of our study was to evaluate these markers in a group of ONBs. We included 11 ONBs from 4 large universi...

Background: Meniscus extrusion is a serious and relatively frequent clinical problem. For this reason the role of different risk factors for this pathology is still the subject of debate. The goal of this study was to verify the results of previous theoretical work, based on the mathematical models, regarding a relationship between the cross-secti...

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Tractography is a tool available in a growing number of centres, to enable planning of neurosurgical interventions. This method has some drawbacks and due to its increasing availability is causing a growing controversy over the possibility of an anatomical mapping of the nerve fibres. This article aims at summarising the application of the diffusio...

Background: The evidence accumulates that the response to acetazolamide test is delayed on the ipsilateral side to stenosis. However, the effect of acetazolamide beyond 30 minutes after acetazolamide administration remains unknown. The aim of this study was to assess the diameters of: anterior cerebral arteries (ACAs), middle cerebral arteries (MC...

The common access to imaging methods based on ionizing radiation requires also radiation protection. The knowledge of ionizing radiation exposure risks among the medical staff is essential for planning diagnostic procedures and therapy. Evaluation of the knowledge of radiation safety during diagnostic procedures among the medical staff. The study c...

Purpose The triple-H therapy is widely used for cerebral vasospasm (CV) prevention and treatment in patients after subarachnoid haemorrhage (SAH). However, this practice is based on low level evidence. Aim of this study was to evaluate errors in fluid administration, fluid balance monitoring and bedside charts completeness during a trial of triple-...

Background: The aim of this study was to investigate the morphometry of the posterior communicating artery (PCoA), on the basis of angio-computed tomography (CT), and to give proof of the mathematical definition of the term "hypopal sia of the PCoA". Materials and methods: One hundred 3-dimensional (3D) angio-CT images, performed in adult patien...

Trigeminal neuralgia is still a riddle, especially in the pathophysiology of the ticdouloureux, although the problem has been described in many medical publications. The major theory of pain based on the compression of the Vth nerve by tumours or vessels in the rood entry zone (REZ) does not explain the facial pain in patient without neurovascular...

Due to its confirmed neuroprotective properties, sevoflurane is one of a few anaesthetics used for neuroanaesthesia. Its effects on the cerebral and systemic circulations may be of particular importance in patientswith intracranial pathology. This study aimed to evaluate the effect of sevoflurane at concentrations lower than 1 MAC on cerebral perfu...

Multiple myeloma rarely presents with neurological symptoms. We describe two patients with pseudo-stroke manifestation of multiple myeloma. The first patient was a 60-year-old female with the initial presentation of multiple myeloma forming a large skull tumour compressing the brain with resultant symptoms of aphasia, limited logical contact and ri...

Aim: Shunt-dependent chronic hydrocephalus (SDCH) is a common complication after aneurysmal subarachnoid hemorrhage (SAH). There are suggestions that fenestration of the lamina terminalis (LT) can significantly decrease the incidence of the above complication. The aim of this study was to compare retrospectively the incidence of SDCH between patien...

Treatment of chronic low back pain (LBP) after lumbar spine trauma is challenging. Despite fixation of the fractured spine, chronic pain afflicts most of these patients. Spinal cord stimulation (SCS) is a treatment option with an unsatisfactory success rate for low back pain [1], which is attributed to inadequate coverage of painful area [2]. The c...

An analysis of predictors of mortality in patients with ruptured intracranial aneurysm is an important aspect in the assessment of outcome. The aim of the study was to analyse factors determining mortality risk after the surgical treatment of ruptured internal carotid artery (ICA) aneurysm. This study comprised 242 patients operated on between 1997...

The etiology of trigeminal neuralgia is heterogeneous and the pathomechanism has not been established yet. Along with the development of the medicin, innovative techniques are being discovered and they are an alternative or complementary method to the pharmacological treatment. The percutaneous thermal electrocoagulation of Gasserian ganglion is on...

Intraorbital tumours are the wide variety of pathologies lesions (tumours arising from bone, neural structures, tumours of mesenchymal origin, lesions of vascular origin, metastatic, dermoid and epidermoid tumours) often have the same clinical presentation. It results from the location of plenty of the anatomical neurovascular structures in the lim...

Much attention has been paid in the neurosurgical literature to optimising the approaches to intracranial pathology. The aims of the innovations reported are to increase the safety of operations by reduction of brain retraction and to improve exposure of the neurovascular structure in the operating area. It was our intention to investigate whether...

We describe a case involving a ruptured intradural aneurysm of the meningeal branch of the occipital artery arising from the external carotid artery and connecting with the caudal loop of the posteroinferior cerebellar artery (PICA) by the dural fistula. Angiography of the left external carotid artery showed a saccular aneurysm of the occipital art...

Background and purpose: Surgical treatment of pathologies of the interpeduncular fossa (aneurysms of the complex of apex of basilar artery, craniopharyngiomas, pituitary adenomas, meningiomas arising from the clivus and tuberculum sellae and medial part of the sphenoid ridge, clivus chordomas) is still a challenge for neurosurgeons. Despite the mod...

The goal of minimally invasive surgery in the treatment of lumbar discopathy is to achieve outcomes comparable to those of conventional surgery, with minimal risk of perioperative iatrogenic injury. Over the last two decades we have observed remarkable progress in the development of new surgical techniques: chemonucleolysis, transcutaneous discoide...

The development of microscopy, laser technology, endoscopy, and video and image guidance systems has provided the foundation on which minimally invasive spinal surgery is based. Minimally invasive treatments have been undertaken in all areas of the spinal axis since the 20th century. Lumbar disc disease has been treated using chemonucleolysis, perc...

Rules of geometry and stereomorphometry are often applied to narrow and deep neurosurgical approaches. Methods of research are based on the direct cadaver measurements, radiological analysis and intraoperative measurements. Newly developed devices allow direct morphometry to be performed in vivo, during the operation. We describe the use of the neu...