Acta neurochirurgica
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Acta neurochirurgica · Feb 2010
Skin complications in deep brain stimulation for Parkinson's disease: frequency, time course, and risk factors.
Deep brain stimulation (DBS) has been recognized as an efficacious treatment for movement disorders. Its beneficial effects however may be lost due to skin complications such as erosions or infections over the implanted foreign material. We sought to document skin complications in the entire Parkinson's disease patient population who received a DBS system at the Marburg/Kassel implantation centre since the start of our DBS program in January 2002 to analyze frequency, time course, and possible risk factors. ⋯ We conclude that (1) PD patients have a risk for skin complications after DBS as long as the system remains in situ and (2) there are at present no identifiable risk factors for skin complications after DBS, other than PD itself.
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Acta neurochirurgica · Feb 2010
Aneurysmal subarachnoid hemorrhage diagnosis with computed tomographic angiography and OsiriX.
Recent advances in computed tomographic angiography (CTA) have resulted in its replacing digital subtraction angiography (DSA). However, CTA requires a powerful workstation and experienced technicians for image postprocessing. OsiriX, a free open-source medical imaging software with powerful three-dimensional (3D) capability, enables neurosurgeons to perform 3D rendering without extensive training. In this study, we examined the sensitivity and specificity of CTA with OsiriX as the primary diagnostic tool for intracranial aneurysms. ⋯ CTA with OsiriX enables accurate detection of intracranial aneurysms. Cerebral DSA should be reserved for those patients with negative CTA findings.
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Acta neurochirurgica · Feb 2010
Blood volume measurement with indocyanine green pulse spectrophotometry: dose and site of dye administration.
(1) To determine the optimal administration site and dose of indocyanine green (ICG) for blood volume measurement using pulse spectrophotometry, (2) to assess the variation in repeated blood volume measurements for patients after subarachnoid hemorrhage and (3) to evaluate the safety and efficacy of this technique in patients who were treated for an intracranial aneurysm. ⋯ There is no significant difference between intravenous administration of either 10 or 25 mg ICG, and this can be injected through either a peripheral or central venous catheter. The 7.5% coefficient of variation in BV measurements determines the detectable differences using ICG pulse spectrophotometry.
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Acta neurochirurgica · Feb 2010
EditorialTrigeminal neuralgia: a plea for microvascular decompression as the first surgical option. Anatomy should prevail.
Arguments are given to plead why micro-vascular decompression should be the first surgical option to treat primary trigeminal neuralgias resistant to anticonvulsants.