Clinical neurology and neurosurgery
-
Clin Neurol Neurosurg · Sep 2014
ReviewApplication of diffusion tensor imaging and tractography of the optic radiation in anterior temporal lobe resection for epilepsy: a systematic review.
Approximately 50-100% of patients with temporal lobe epilepsy undergoing anterior temporal lobe resection (ATLR) will suffer a postoperative visual field defect (VFD) due to disruption of the optic radiation (OpR). ⋯ DTI shows potential to be an effective method used in planning ATLR. Findings from a single modest sized study suggest that tractography may be employed as part of intraoperative navigation techniques in order to avoid injury to the OpR. Further research needs to be conducted to ensure the applicability and effectiveness of this technology before implementation in routine clinical practice.
-
Clin Neurol Neurosurg · Sep 2014
Randomized Controlled Trial Multicenter StudyInterspinous spacer decompression (X-STOP) for lumbar spinal stenosis and degenerative disk disease: a multicenter study with a minimum 3-year follow-up.
Interspinous distraction devices provide an effective treatment for patients suffering from lumbar spinal stenosis and/or degenerative disk disease. The aim of this multicenter study was the prospective evaluation of patients treated for symptomatic lumbar spinal stenosis with interspinous process decompression (IPD) implants compared with a population of patients managed with conservative treatment. 542 patients affected by symptomatic lumbar spine degenerative disease were enrolled in a controlled trial. 422 patients underwent surgical treatment consisting of X-STOP device implantation, whereas 120 control cases were managed conservatively. Both patient groups underwent follow-up evaluations at 6, 12, 24, and 36 months using the Zurich Claudication Questionnaire, the Visual Analog Scale score and spinal lumbar X-rays, CT scans and MR imaging. ⋯ In 24 of 422 patients, the IPD device had to be removed, and a decompression and/or pedicle screw fixation was performed because of the worsening of neurological symptoms. Our results support the effectiveness of surgery in patients with stenosis. IPD may offer an effective and less invasive alternative to classical microsurgical posterior decompression in selected patients with spinal stenosis and lumbar degenerative disk diseases.
-
Clin Neurol Neurosurg · Sep 2014
Quality of life in advanced Parkinson's disease after bilateral subthalamic stimulation: 2 years follow-up study.
The aims of this study were to assess the quality of life (QoL) using Parkinson's Disease Questionnaire PDQ-39 after bilateral subthalamic deep brain stimulation (STN DBS), and to identify correlations between changes in UPDRS score and separate PDQ-39 QoL dimensions and PDQ summary index (SI) score at long-term follow-up. ⋯ STN DBS significantly improved important aspects of QoL as measured by PDQ-39. The improvements were maintained at 2 years follow-up except for social support and communication. We demonstrated a positive correlation between changes in the off condition of motor UPDRS scores and dyskinesia UPDRS scores in several PDQ-39 dimensions, whereas fluctuation UPDRS scores were negatively correlated with PDQ-39 mobility scores.
-
Clin Neurol Neurosurg · Sep 2014
Clinical features associated with sleep disturbances in Parkinson's disease.
Sleep disturbances, such as REM sleep behavior disorder (RBD) and excessive daytime sleepiness, are more common in patients with Parkinson's disease (PD) than in the general population. Apart from that, their relation to PD seems to diverge considerably. Our aim was to explore the frequency and associated motor- and non-motor features of sleep related symptoms in PD. ⋯ Our results suggest that excessive daytime sleepiness is related to disease duration, and possibly caused by progressive neurodegeneration. pRBD seems to be a distinct feature present in only a proportion of PD patients.
-
Clin Neurol Neurosurg · Sep 2014
Comparative StudyCryopreservation versus subcutaneous preservation of autologous bone flaps for cranioplasty: comparison of the surgical site infection and bone resorption rates.
Decompressive craniectomy is performed to treat malignant brain hypertension. Surgical site infection (SSI) and bone resorption are common complications following cranioplasty, and the storage method that minimizes such complication has yet to be identified. ⋯ In this series, the SSI rates were similar in the SP and CP groups. There was no significant difference when the patients were grouped by TBI etiology. The incidence of bone flap resorption in the CP group was higher than that in the SP group. However, identifying of the method that yields superior results might depend on the individual surgeon's preference and the available equipment.