Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2011
Transsphenoidal surgery assisted by a new guidance device: results of a series of 747 cases.
The objective of this study is to report the efficacy and safety of microsurgical transsphenoidal surgery using a frame for sella guidance in a series of patients with untreated pituitary adenoma. ⋯ The endonasal transsphenoidal technique is a safe, quick, and effective approach to pituitary adenomas. Our guidance frame allows the surgeon to open and close the wound rapidly, which avoids trajectory deviation and shortens the duration of the surgical procedure.
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Clin Neurol Neurosurg · Oct 2011
Cognitive and functional impairments in ischemic stroke patients with concurrent small vessel and large artery disease.
Concurrent small vessel, intracranial and extracranial large artery disease (SLAD) is common in Asian but its impact on cognitive and functional outcomes is unclear. We aimed to evaluate the clinical, cognitive and functional outcomes in ischemic stroke patients with SLAD. ⋯ This was the first MRA-based study to take into consideration the clinical, cognitive and functional outcomes in ischemic stroke patients with SLAD. Patients with SLAD had poorer cognitive and functional outcomes when compared to patients without SLAD.
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Clin Neurol Neurosurg · Oct 2011
Anterior subcutaneous transposition of ulnar nerve with fascial flap and complete excision of medial intermuscular septum in cubital tunnel syndrome: a prospective patient cohort.
Regarding the frequency of cubital tunnel syndrome, varieties of treatment modalities, and ambiguity of anterior subcutaneous transposition of ulnar nerve method, we aimed to evaluate the efficacy of this procedure in patients with cubital tunnel syndrome referred to Taleghani hospital between 2006 and 2009. ⋯ Though considered standard of care, the present study suggests that criteria for surgical techniques of ulnar nerve decompression, e.g. simple decompression vs. more extensive repair as in the present cohort, should be revised by controlled prospective studies.
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Clin Neurol Neurosurg · Sep 2011
Clinical TrialShort duration repetitive transcranial magnetic stimulation for tinnitus treatment: a prospective Asian study.
Tinnitus is a subjective auditory perception of sounds or noise not triggered by external auditory stimuli. To date, treatment in severe cases is generally unsatisfactory. Characteristic functional brain imaging changes associated with tinnitus include hyperactivity encompassing both the primary auditory cortex (AC) and the secondary or associative cortex. Brief repetitive transcranial magnetic stimulation (rTMS) trains applied to the scalp overlying the hyperactive left AC is known to produce moderate tinnitus attenuation. ⋯ Our findings point to a positive effect of short duration rTMS in tinnitus treatment using the THI. However, no significant benefits were demonstrated for other subjective patient ratings. Although well tolerated and convenient, short duration rTMS may prove inadequate for modulating maladaptive plastic changes at the cortical level, and our results suggest the need for delivery of more stimuli. Future studies will utilize at least 2000 pulses/day, in line with previous experience in Western settings.