Acta neurochirurgica
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Acta neurochirurgica · Apr 2015
Results of nerve reconstructions in treatment of obstetrical brachial plexus injuries.
The aim of this study was to evaluate the results achieved using various surgical techniques in patients with partial and total obstetrical brachial plexus palsy. ⋯ Improved function can be obtained in infants with obstetrical brachial plexus injury with early surgical reconstruction.
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Acta neurochirurgica · Apr 2015
Guiding protractor for accurate freehand placement of ventricular catheter in ventriculoperitoneal shunting.
While frameless stereotaxis can be used for shunt ventricular catheter placement in patients with smaller ventricles, the ventricular catheter is still commonly placed based on the surface anatomy of the head for patients with larger ventricles. Thus, surgical techniques and guides facilitating accurate and reliable freehand placement of the ventricular catheter still need to be devised. ⋯ The proposed surgical technique using a guiding protractor facilitates accurate freehand placement of a ventricular catheter for patients with a bicaudate index >0.2 or bifrontal distance >25 mm.
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Acta neurochirurgica · Apr 2015
Higher impact energy in traumatic brain injury interferes with noncovalent and covalent bonds resulting in cytotoxic brain tissue edema as measured with computational simulation.
Cytotoxic brain tissue edema is a complicated secondary consequence of ischemic injury following cerebral diseases such as traumatic brain injury and stroke. To some extent the pathophysiological mechanisms are known, but far from completely. In this study, a hypothesis is proposed in which protein unfolding and perturbation of nucleotide structures participate in the development of cytotoxic edema following traumatic brain injury (TBI). ⋯ Based on the analysis of the numerical simulation data, the kinetic energy from an external dynamic impact has the theoretical potential to interfere not only with noncovalent, but also with covalent bonds when high enough. The subsequent attraction of increased water molecules into the unfolded protein structures and disruption of adenosine-triphosphate bonds could to some extent explain the etiology to cytotoxic edema.
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Acta neurochirurgica · Mar 2015
Comparative StudyAccuracy of subthalamic nucleus targeting by T2, FLAIR and SWI-3-Tesla MRI confirmed by microelectrode recordings.
Successful deep brain stimulation is mostly dependent on accurate positioning of the leads at the optimal target points. We investigated whether the identification of the subthalamic nucleus in T2-weighted 3-T MRI, fluid-attenuated inversion recovery 3-T MRI and susceptibility-weighted 3-T MRI is confirmed by intraoperative neurological microelectrode recording. ⋯ The susceptibility-weighted 3-T MRI-based subthalamic nucleus localization shows the best accuracy compared with T2-weighted and fluid-attenuated inversion recovery 3-T MRI. Therefore, the susceptibility-weighted 3-T MRI should be preferred for surgical planning when the operation procedure is performed under general anesthesia without microelectrode recordings.