Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Nov 2014
Magnetic resonance imaging predictors for respiratory failure after cervical spinal cord injury.
Patients after cervical spinal cord injury (CSCI) may experience ventilator-dependent respiratory failure during the acute hospitalization period. The aim of the study is to identify imaging factors that predict respiratory failure after acute CSCI. ⋯ MRI can accurately localize CSCI and identify those patients at risk of respiratory failure. Imaging level of injury at C3 and presence of spinal cord edema are both predictors. To prevent secondary cord injury from prolonged hypoxia and facilitate pulmonary care, definitive airways should be established early in high risk patients.
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Clin Neurol Neurosurg · Nov 2014
Long-term outcomes of bilateral pallidal stimulation for primary generalised dystonia.
Bilateral pallidal stimulation is an established surgical management for patients with primary generalised dystonia (PGD). The aim of this study was to present our long-term experience of bilateral pallidal stimulation in patients with PGD. ⋯ Our results indicate that bilateral pallidal stimulation is an effective treatment for patients with DYT-1 positive and DYT-1 negative PGD. The most common hardware-related complication (DBS lead breakage) in our series was associated with the slippage of the connector to the cervical area. To prevent this complication after changing the surgical technique (suturing and placing the connector in parietal region) we did not observe these complications. Unilateral IPG failure resulted in the development of severe status dystonicus.
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Clin Neurol Neurosurg · Nov 2014
Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures.
Endoscopic third ventriculostomy (ETV) is the treatment of choice for obstructive hydrocephalus, but the outcome is still controversial in terms of age and aetiology. ⋯ ETV is a safe procedure and an effective treatment for obstructive hydrocephalus even following the dysfunction of previous VPSs and in children younger than two years.
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Clin Neurol Neurosurg · Nov 2014
Case ReportsTrue aneurysms of the superficial temporal artery: Diagnosis and treatment.
True aneurysms arising from the superficial temporal artery (STA) are quite uncommon. The present study reviews the surgical experience with true STA aneurysms to describe the clinical features and treatment options. ⋯ True STA aneurysms are usually discovered as a pulsating mass over the temple and their diagnosis could be done with ultrasonography, and computed tomography and magnetic resonance angiography. Simple ligation and resection of the aneurysm is safe and curative.
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Clin Neurol Neurosurg · Nov 2014
Cerebral metabolism during experimental endotoxin shock and after preconditioning with monophosphoryl lipid A.
Preconditioning with low doses of monophosphoryl lipid A (MPL) has been shown to induce endotoxin tolerance and to reduce the metabolic and hemodynamic consequences of endotoxin shock. However, no data are available about the effects of endotoxin preconditioning on cerebral metabolism during endotoxemia. The study was designed to determine the effects of endotoxin preconditioning with MPL on cerebral metabolism via microdialysis compared to muscle tissue metabolism during experimental endotoxemia. ⋯ Preconditioning with low doses of MPL ameliorates the negative metabolic effects of endotoxin shock in muscle tissue. With regard to cerebral metabolism, the present study suggests that MLP preconditioning provides moderate advantages, at least in an experimental model of endotoxin shock.