Acta neurochirurgica
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Acta neurochirurgica · Jan 2012
The effect of common carotid artery occlusion on delayed brain tissue damage in the rat double subarachnoid hemorrhage model.
Delayed ischemic brain tissue damage in the time course of cerebral vasospasm in the rat double-subarachnoid hemorrhage (SAH) model has been described before. However, in order to enhance hemodynamic insufficiency during cerebral vasospasm (CVS), we performed-in a modification to the standard double-hemorrhage model-an additional unilateral common carotid artery occlusion (CCAO), expecting aggravation of brain-tissue damage in areas particularly sensitive to hypoxia. ⋯ CCAO leads to an aggravation of CVS-related delayed brain tissue damage in the modified rat double-SAH model.
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Acta neurochirurgica · Dec 2011
ReviewInfundibulo-tuberal or not strictly intraventricular craniopharyngioma: evidence for a major topographical category.
This study investigates retrospectively the clinical, neuroradiological, pathological and surgical evidence verifying the infundibulo-tuberal topography for craniopharyngiomas (CPs). Infundibulo-tuberal CPs represent a surgical challenge due to their close anatomical relationships with the hypothalamus. An accurate definition of this topographical category is essential in order to prevent any undue injury to vital diencephalic centres. ⋯ Infundibulo-tuberal CPs represent a major topographical category of lesions with a primary subpial development at the floor of the third ventricle. These lesions expand within the hypothalamus itself and subsequently occupy the third ventricle; consequently, they can be classified as not strictly intraventricular CPs. A tight attachment to the hypothalamus and remnants of the third ventricle floor is the pathological landmark of infundibulo-tuberal CPs.
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Acta neurochirurgica · Dec 2011
ReviewExpanding applications of deep brain stimulation: a potential therapeutic role in obesity and addiction management.
The indications for deep brain stimulation (DBS) are expanding, and the feasibility and efficacy of this surgical procedure in various neurologic and neuropsychiatric disorders continue to be tested. This review attempts to provide background and rationale for applying this therapeutic option to obesity and addiction. We review neural targets currently under clinical investigation for DBS—the hypothalamus and nucleus accumbens—in conditions such as cluster headache and obsessive-compulsive disorder. These brain regions have also been strongly implicated in obesity and addiction. These disorders are frequently refractory, with very high rates of weight regain or relapse, respectively, despite the best available treatments. ⋯ Well-designed pilot studies and clinical trials enrolling carefully selected patients with obesity or addiction should be initiated.