Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jul 2019
Analysis of factors influencing ligamentum flavum thickness in lumbar spine - A radiological study of 1070 disc levels in 214 patients.
The pathomechanism and factors influencing hypertrophy of the Ligamentum flavum in the lumbar spine still requires a confident specificity. We aimed to analyse the association between various factors and Ligamentum Flavum Thickness (LFT) and also to investigate the major contributor for Ligamentum Flavum Hypertrophy (LFH) at various levels in the lumbar spine. ⋯ Higher Pfirrmann's grade and decreased anterior disc height can lead to ligamentum flavum hypertrophy at L1-L2, L2-L3,L3-L4,L4-L5 levels.Whereas at L5-S1 level, it is the presence of facet tropism which can cause LFH. Hence, patients with the presence of above mentioned factors at those respective levels have higher preponderance to develop Lumbar canal stenosis.
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Clin Neurol Neurosurg · Jul 2019
Prognostic significance of O6-methylguanine-DNA-methyltransferase (MGMT) promoter methylation and isocitrate dehydrogenase-1 (IDH-1) mutation in glioblastoma multiforme patients: A single-center experience in the Middle East region.
To determine the prevalence and prognostic value of MGMT promoter methylation and IDH1 mutation in glioblastoma multiforme (GBM) patients from the Middle East. ⋯ Patients with GBM from the Middle East have adequate survival outcomes when given the optimal treatment. In our patient population, MGMT promoter methylation did not seem to correlate with outcomes, but patients with IDH1 mutation had numerically higher survival outcomes.
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Clin Neurol Neurosurg · Jul 2019
Transcalvarial brain herniation volume as a predictor of posttraumatic hydrocephalus after decompressive craniectomy.
In patients undergoing decompressive craniectomy for traumatic brain injury(TBI) there has been reported an incidence of hydrocephalus between 0-45%. There are several radiological and clinical features described in association with development of hydrocephalus. For study the influence of these factors we conducted a retrospective observational single-center cohort study in a tertiary care center with special attention to the transcalvarial herniation(TCH) volume after decompressive craniectomy. ⋯ There was a clear association between severity of TBI, TCH volume and subdural hygroma with the development of hydrocephalus. Clinicians should follow closely patients with those findings in order to avoid late deterioration.
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Clin Neurol Neurosurg · Jun 2019
Deterministic-tractography-based approach for diagnosis and disease monitoring of amyotrophic lateral sclerosis.
Upper and lower motor neuron signs are required for the diagnosis of amyotrophic lateral sclerosis. The detection of upper motor neuron signs is key for the diagnosis, as quite a few patients with amyotrophic lateral sclerosis lack upper motor neuron signs during the course of disease. This study sought to investigate whether deterministic tractography of the corticospinal tract, reflecting upper motor neuron signs, could be a surrogate biomarker for amyotrophic lateral sclerosis. ⋯ These findings suggest that the deterministic-tractography-based approach is a potential biomarker for the diagnosis and disease monitoring of amyotrophic lateral sclerosis.
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Clin Neurol Neurosurg · Jun 2019
Impact of sagittal imbalance correction on clinical outcomes in patients undergoing MIS-TLIF for LSS.
In the present study, we aimed to evaluate the effect of sagittal imbalance correction on clinical outcomes in patients undergoing single-segment minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar spinal stenosis (LSS). ⋯ A significant proportion of LSS patients with preoperative sagittal malalignment had a compensatory mechanism rather than a structural malalignment, while single-segment MIS-TLIF could effectively improve sagittal imbalance at 2-year follow-up. However, we found no correlation between the improvements of sagittal imbalance and 2- year clinical outcomes. Reconstruction of sagittal balance might not be the main goal of single-segment MIS-TLIF for LSS, and did not affect its clinical results at two-year follow-up.