Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Mar 2016
Stratification of predictive factors to assess resectability and surgical outcome in clinoidal meningioma.
Meningiomas of the clinoidal region pose significant surgical challenges due to their close proximity and intimate relation with surrounding critical neurovascular structures. Our aim was to describe our institution's experience with the management of clinoidal meningiomas, identify predictive factors and develop a comprehensive grading system to assess the extent of resection. ⋯ A grading system can be employed in patients who present with clinoidal meningiomas and serve as an aid in planning an appropriate treatment strategy and establishing the prognosis. Radical resection can be planned in patients with favorable tumor criteria (groups 1) while a less aggressive surgical approach followed by stereotactic radiosurgery may be better suited for patients with less favorable tumor characteristics (group 2).
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Clin Neurol Neurosurg · Mar 2016
ReviewSecond surgery for recurrent glioblastoma: A concise overview of the current literature.
Optimal treatment for recurrent glioblastoma continues to evolve. Currently, however, there is no consensus in the literature on the role of reoperation in the management of these patients, as several studies provide evidence for a longer overall survival in selected patients with recurrent glioblastoma who underwent second surgery and other studies report a limited impact of second surgery in the clinical course. In this paper, a review of the current literature was performed to analyze the role of reoperation in patients with recurrent glioblastoma and to report the overall survival from diagnosis, progression-free survival and quality of life. ⋯ The median overall survival from diagnosis and the median survival from second surgery were 18.5 months and 9.7 months, respectively. Extent of resection at reoperation improves overall survival, even in patients with subtotal resection at initial operation. Preoperative performance status and age are important predictors of a longer survival, reason why younger patients with a good preoperative performance status could benefit from reoperation.
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Clin Neurol Neurosurg · Mar 2016
Deep Brain Stimulation of the internal globus pallidus in refractory Tourette Syndrome.
Deep Brain Stimulation in psychiatric disorders is becoming an increasingly performed surgery. At present, seven different targets have been stimulated in Tourette Syndrome, including the internal globus pallidus. We describe the effects on tics and comorbid behavioral disorders of Deep Brain Stimulation of the anterior internal globus pallidus in five patients with refractory Tourette Syndrome. ⋯ Our study suggests that Deep Brain Stimulation of the anterior internal globus pallidus is effective in reducing tic severity, and possibly also obsessive-compulsive behavior, in refractory Tourette patients without serious adverse events or side-effects.
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Clin Neurol Neurosurg · Mar 2016
Risk rtPA: An iOS mobile application based on TURN for predicting 90-day outcome after IV thrombolysis.
We recently developed Thrombolysis risk Using mRS and NIHSS (TURN), a simple score using only prestroke mRS scores and admission NIHSS scores to predict 90-day outcome after IV thrombolysis in ischemic stroke patients. Our purpose was to develop and test a mobile application for utilization of TURN at the bedside. ⋯ The Risk rtPA mobile application predicted 90-day excellent and severe outcome in most clinically relevant cases. This mobile application brings the TURN score to the bedside for prediction of 90-day outcome in ischemic stroke patients being evaluated for IV thrombolysis.
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Device subsidence is a well-known complication following cervical disc arthroplasty. Its occurrence has been closely tied with the endplate-implant contact interface. But current literature on the geometry of cervical endplate is very scarce. The aim of this anatomical investigation was to analyze geometry of inferior endplates of the cervical vertebrae, thereby identifying the common endplate shape patterns and providing morphological reference values consummating the design of the implant. ⋯ The exact shape and geometry of cervical endplate are crucial for the design and improvement of cervical disc prosthesis. Gender difference of sagittal and transverse diameters of cervical endplate should be given more attention when implanting a disc prosthesis. These endplate geometrical parameters should be taken into consideration when calculating most suitable geometric parameters of new disc prosthesis.