Acta neurochirurgica
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Acta neurochirurgica · Oct 2011
Case ReportsTriceps brachii reinnervation in primary reconstruction of the adult brachial plexus: experience in 25 cases.
Elbow flexion and shoulder abduction are the primary goals in brachial plexus surgery; however, reinnervation of the triceps is also an objective to be considered, as restoration of elbow extension improves the stabilization of the elbow and can provide a more powerful grasp. This study aims to demonstrate the author's experience with restoration of elbow extension function in cases of brachial plexus surgery in adults. ⋯ Reinnervation of the triceps can be achieved in most patients if adequate donor and recipient nerves are carefully selected based on an individual case-specific decision.
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Acta neurochirurgica · Oct 2011
Chemoport with a non-collapsible chamber as a replacement for an Ommaya reservoir in the treatment of leptomeningeal carcinomatosis.
The Ommaya reservoir for intraventricular chemotherapy of leptomeningeal carcinomatosis (LMC) patients has been reported to have some complications. We introduced a Chemoport reservoir, with a solid non-collapsible, high-profile chamber as a the replacement for the Ommaya reservoir in LMC patients. ⋯ Chemoport, as a reservoir for intraventricular chemotherapy, has superior ICP control at an equal or lower rate of complications compared with the Ommaya reservoir.
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Acta neurochirurgica · Oct 2011
Case ReportsIntraoperative monitoring of the visual function using cortical potentials after electrical epidural stimulation of the optic nerve.
Central skull base meningiomas commonly present with visual deficit, and their removal often leads to improvement of visual function. However, the incidence of postoperative visual deterioration has been reported to be up to 10%. Intraoperative monitoring using flash visual evoked potential has only recently been used with success. Cortical potentials (CP) after electrical epidural stimulation of the optic nerve (ON) were correlated with ON manipulation due to central skull base tumor removal to contribute to improvement of the intraoperative monitoring of the visual function. ⋯ P20 and N30 amplitude changes seem to reliably correspond with the manipulation of ON during anterior skull base tumor removal. Reversible reduction of P20 and N30 amplitude was associated with unchanged immediate postoperative visual function. No correlation between intraoperative variation of CP and newly acquired postoperative visual deficit can presently be made.
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Acta neurochirurgica · Oct 2011
Effects of combining electrical stimulation with BDNF gene transfer on the regeneration of crushed rat sciatic nerve.
Various techniques have been investigated to enhance peripheral nerve regeneration including the application of low-intensity electrical stimulation (ES) and the administration of growth factors, especially brain-derived neurotrophic factor (BDNF). The purpose of this study was to investigate the effects of combining short-term (ES) and recombinant adenoviral vector-mediated BDNF (BDNF-Ad) transfer, in comparison to each sole modality, on peripheral nerve regeneration in a rat model with crush-injured sciatic nerve. ⋯ Both the ES and the BDNF-Ad treatments were effective techniques enhancing the sciatic nerve regeneration following a crush injury in rats. Nevertheless, the combined treatment with ES and BDNF-Ad produces neither a synergistic effect nor an improvement in this injury model.