Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Apr 2010
Comparative StudyLow field intraoperative MRI-guided surgery of gliomas: a single center experience.
The aim of this article is to report on our experience in using a low field intraoperative MRI (iMRI) system in glioma surgery and to summarize the hitherto use and benefits of iMRI in glioma surgery. ⋯ Low field iMRI is a helpful tool in modern neurosurgery and facilitates brain tumor resection to a maximum safe extent. Its use translates into a better prognosis for these patients with devastating tumors. Future studies covering the use of iMRI will need to be conducted in a prospective, randomized fashion to prove the true benefit of iMRI in glioma surgery.
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Clin Neurol Neurosurg · Apr 2010
Comparative StudyShort-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC).
Many patients with brain metastases due to SCLC have a poor survival prognosis. The most common treatment is whole-brain radiotherapy (WBRT). This retrospective study compares short-course WBRT with 5x4Gy in 1 week to standard WBRT with 10x3Gy in 2 weeks. ⋯ In patients with brain metastases due to SCLC, short-course WBRT with 5x4Gy provided similar outcomes as 10x3Gy and appears preferable, particularly for patients with poor estimated survival.
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Clin Neurol Neurosurg · Apr 2010
Differential diagnosis of intracranial ring enhancing cystic mass lesions--role of diffusion-weighted imaging (DWI) and diffusion-tensor imaging (DTI).
To evaluate the contribution of DWI and DTI to the differential diagnosis of cerebral ring enhancing lesions by describing DWI and ADC (apparent diffusion coefficient) findings and measuring the two DTI parameters mean diffusivity (MD) and fractional anisotropy (FA). ⋯ The findings of reduced diffusion compared to NAWM and increased FA within a ring enhancing cyst strongly indicate a cerebral abscess. In contrast, the majority of neoplastic cysts revealed high diffusion and low FA. Reduced diffusion is also found in a very small number of tumour cysts, but in these low FA refers to a non-infectious origin and thus helps distinguishing from infectious abscess.
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Clin Neurol Neurosurg · Feb 2010
Unilateral deep brain stimulation of the nucleus accumbens in patients with treatment-resistant obsessive-compulsive disorder: Outcomes after one year.
To investigate the effects of unilateral deep brain stimulation (DBS) in the right nucleus accumbens in patients with obsessive-compulsive disorder (OCD). Predominantly bilateral stimulation of the anterior limb of the internal capsule was utilized. ⋯ DBS of the unilateral right nucleus accumbens showed encouraging results in patients with treatment-resistant OCD. Five out of ten patients reached at least a partial response after the first year.
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Clin Neurol Neurosurg · Jan 2010
Reprogramming guided by the fused images of MRI and CT in subthalamic nucleus stimulation in Parkinson disease.
To evaluate the usefulness of the visual information about the location of the contacts in deep brain stimulation (DBS) programming, we compared the outcomes of subthalamic nucleus (STN) stimulation before and after reprogramming guided by the fused images of MRI and CT. ⋯ CT-MR fusion images helped to reprogram stimulation parameters with ease and confidence in a time-saving manner and resulted in further clinical improvement. This method could complement the conventional method of adjusting stimulation parameters after bilateral STN-DBS.