Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Mar 2015
Comparative StudyFunctional and sensory evaluation of patients with idiopathic trigeminal neuralgia: comparison with controls.
Idiopathic trigeminal neuralgia (ITN) can be associated with orofacial and sensory comorbidities. ⋯ ITN may cause severe mandibular limitations that can be associated with the pain episodes and with sensory abnormalities. These findings indicate the affection of small and large nerve fibers and support the neuropathic nature of ITN. Sensory alterations can be part of the natural history of ITN and can be associated with the previous treatments including medication. They cause a high impact in quality of life.
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Clin Neurol Neurosurg · Mar 2015
Risk factors for incidental durotomy during lumbar surgery: a retrospective study by multivariate analysis.
The purpose of the present study was to use a prospectively collected data to evaluate the rate of incidental durotomy (ID) during lumbar surgery and determine the associated risk factors by using univariate and multivariate analysis. ⋯ Older age, prior lumber surgery, revision surgery, and minimal invasive surgery were independent risk factors for ID during lumbar surgery. These findings may guide clinicians making future surgical decisions regarding ID and aid in the patient counseling process to alleviate risks and complications.
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Clin Neurol Neurosurg · Mar 2015
Brain metabolism assessed via proton magnetic resonance spectroscopy in patients with amnestic or vascular mild cognitive impairment.
To address the possible role of brain regional metabolic differences between different types of mild cognitive impairment (MCI). ⋯ This study indicated that there are differences in metabolism related to brain regions between A-MCI and V-MCI, thus it may be concluded that 1H MRS may be a useful tool to differentiate A-MCI and V-MCI.
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Clin Neurol Neurosurg · Mar 2015
Changing the needle for lumbar punctures: results from a prospective study.
Post-dural puncture headache (PDPH) is a common complication of diagnostic lumbar punctures. Both a non-cutting needle design and the use of smaller size needles have been shown to greatly reduce the risk of PDPH. Nevertheless, larger cutting needles are still widely used. This study describes the process of changing the needle in an outpatient clinic of a Danish neurology department. ⋯ Our study showed that smaller, non-cutting needles reduce the incidence of PDPH and are easily implemented in an outpatient clinic. Changing the needle resulted in fewer socioeconomic complications and fewer overall costs, while also reducing procedural difficulty.
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Clin Neurol Neurosurg · Mar 2015
Disease outcomes for skull base and spinal chordomas: a single center experience.
Chordomas carry significant morbidity due to their growth patterns and surgical constraints in resection. En bloc resection, when feasible, is the ideal treatment goal, but is associated with significant morbidity. We sought to elucidate the relationship between extent of surgery, location and radiotherapy in relation to overall disease and progression free survival (PFS). ⋯ GTR offers the best prognosis for improved long-term survival. Adjuvant HD FSRT for cranio-cervical/clival chordomas significantly improves disease free survival though the long-term benefits on survival have yet to be established. Sacral chordomas are associated with a worse prognosis and poor long-term survival.