Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · May 2013
Comparative StudyDynamic stabilization for degenerative spondylolisthesis: evaluation of radiographic and clinical outcomes.
To evaluate the dynamic stabilization system in degenerative lumbar spondylolisthesis. ⋯ There is significant clinical improvement after laminectomy and dynamic stabilization with Dynesys for lumbar spinal stenosis. While there was restriction (<3°) in segmental ROM, Dynesys provides similar radiographic stability and clinical effects regardless of pre-operative spondylolisthesis.
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Clin Neurol Neurosurg · May 2013
Review Meta AnalysisWhat is the best treatment of drug-resistant trigeminal neuralgia in patients affected by multiple sclerosis? A literature analysis of surgical procedures.
Drug-resistant trigeminal neuralgia (TN) can complicate the clinical course of patients affected by multiple sclerosis (MS). Various surgical procedures have been reported for the treatment of this condition, but there is no agreement on the best management of these patients. To our knowledge, there is no critical literature analysis focusing on this particular topic. The aim of this study was to evaluate the clinical outcome of different surgical procedures utilized for drug-resistant TN in MS patients. ⋯ Our study shows no differences in the short term results among different procedures for TN in MS patients. Each technique demonstrate advantages and limits in terms of long term pain, recurrence rate and complication rate. Each patient should be accurately informed on pros and cons of each procedure in order to be involved in the most appropriate choice.
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Clin Neurol Neurosurg · May 2013
Ischemia changes and tolerance ratio of evoked potential monitoring in intracranial aneurysm surgery.
We assessed the relationship between cerebral ischemia-induced changes in evoked potentials and the degree of ischemia tolerance. ⋯ The Ischemia tolerance ratio (ITR) in SEP recordings is valuable to predicting postoperative neurological deficits caused by temporary occlusion of aneurysm's parent artery. Maintaining the ITR under 50% during operation can effectively avoid postoperative neurological deficits, while an ITR above 80% reliably forecasts postoperative neurological deficits. Complementary to SEPs, MEP recordings are particularly valuable in monitoring ischemic effects caused by accidentally clamping perforating branches. Taken together, this system of monitoring makes it possible to promptly adjust surgery procedures and minimize postoperative neurological deficits.
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Clin Neurol Neurosurg · Apr 2013
Comparative StudyPlasma heart-type fatty acid binding protein level in acute ischemic stroke: comparative analysis with plasma S100B level for diagnosis of stroke and prediction of long-term clinical outcome.
Heart-type fatty acid binding protein (H-FABP) is enriched in neuronal cell body as well as myocardium, and is rapidly released from damaged neuron into circulation in cerebral ischemia. We performed a comparative analysis between plasma H-FABP and S100B levels in the acute phase of ischemic stroke. ⋯ Although plasma H-FABP is elevated in the acute phase of ischemic stroke, the diagnostic accuracy of H-FABP as a sole marker is not sufficient to be applied in the clinical setting. Plasma H-FABP can be used as a potential marker for stroke prognosis.