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
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.
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Acta neurochirurgica · Jan 2010
ReviewUpdate on protein biomarkers in traumatic brain injury with emphasis on clinical use in adults and pediatrics.
This review summarizes protein biomarkers in mild and severe traumatic brain injury in adults and children and presents a strategy for conducting rationally designed clinical studies on biomarkers in head trauma. ⋯ We conclude that only S-100B in severe traumatic brain injury has consistently demonstrated the ability to predict injury and outcome in adults. The number of studies with protein degradation products is insufficient especially in the pediatric care. Cohort studies with well-defined end points and further neuroproteomic search for biomarkers in mild injury should be triggered. After critically reviewing the study designs, we found that large homogenous patient populations, consistent injury, and outcome measures prospectively determined cutoff values, and a combined use of different predictors should be considered in future studies.
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Acta neurochirurgica · Jan 2010
Meningiomas in the elderly, the surgical benefit and a new scoring system.
The purpose of the study was to define and identify prognostic indicators within an elderly population of patients suffering from intracranial meningiomas. The clinical presentation of the patient with meningioma is diverse, manifesting as a different clinical entity in the elderly patient compared to a similar type of tumor in a young patient. ⋯ The present results suggest that common experience-based considerations may be optimized and implemented into a simple scoring system that in turn may allow for outcome prediction and evidence-based decision making