Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jan 2019
Influence of patient positioning on reported clinical outcomes after greater occipital nerve block for treatment of headache: Results from prospective single-centre, non-randomised, proof-of-concept study.
Greater occipital nerve (GON) block is a treatment option applied for a variety of primary headache disorders. Although a patient's body position is known to have an impact on the effect of local anaesthetics, this has not before been investigated for patients undergoing GON block. Therefore, the clinical effectiveness of either a sitting or supine position was assessed. ⋯ Placing a patient in a supine position following a GON block procedure for headache may significantly improve the resulting clinical effectiveness of this treatment. Further research, through a prospective, multi-centre, randomised, controlled trial, is indicated to determine if the initial positive observations in this present pragmatic evaluation can be confirmed.
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Clin Neurol Neurosurg · Jan 2019
Autologous bone dust technique for one burr hole surgery to prevent severe skin depression.
One burr hole surgery is a common treatment modality for initial chronic subdural hematoma and stereotactic hematoma surgery, but severe skin depression is often a postoperative complication. We report the autologous bone dust technique, which uses autogenous bone dust generated during burr hole creation to prevent cosmetic deformity. ⋯ The autologous bone dust technique is effective in preventing skin depression after one burr hole surgery without using artificial materials.
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Clin Neurol Neurosurg · Jan 2019
Comparative StudyEffects of the physician payments sunshine act on the patient experience and perception of care amongst neurosurgeons: A comparative study of online PRW ratings and industry payments.
Growing relationships between industry related financial payments and physicians have become an increasingly controversial topic as they relate to clinical judgment and patient care. Our objective is to analyze and quantify the effects of physician reported industry payments on the patient experience and patient satisfaction as defined by Physician Rating Websites (PRW). ⋯ Patient experience as defined by PRW ratings are likely not strongly influenced by industry related monetary payments, however some relationship may exist. Further study is needed to determine the true relationship between industry related monetary payments and the patient experience.
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Clin Neurol Neurosurg · Jan 2019
Percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar interbody fusion for massive lumbar disc herniation.
To compare the clinical outcomes of patients with massive lumbar disc disease undergoing percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar interbody fusion at a single clinic. ⋯ A comparison of PELD and MIS-TLIF for treating massive lumbar disc herniation revealed that both showed favorable clinical outcomes but had different sets of complications. Compared to MIS-TLIF, PELD had the following advantages: (1) its feasibility under local anesthesia and (2) the rarity of "fusion disease," such as ASD. However, the PELD is also revealed several problems, including a relatively lower success rate and satisfaction,a relative higher rate of postoperative long-term chronic low back pain and the possibility of recurrence, despite low opportunity. Therefore, the main difference between these two treatments was related to postoperative complications and the satisfaction and recovery rates. We suggest that, in the future, multi-center studies, recruiting a larger number of patients, should be undertaken to better understand the clinical relevance of these complications.
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Clin Neurol Neurosurg · Dec 2018
Intracranial clear cell meningioma: Clinical study with long-term follow-up in 24 patients.
Clear cell meningioma (CCM) is a rare disease, and controversy about treatment and prognosis of CCMs still exists. We aimed to clarify the natural history, radiological features, histological characteristics, management and prognosis of intracranial CCMs. ⋯ CCMs are rare diseases which have a predilection to affect younger patients and a high rate of recurrence and metastasis. Surgery resection is the first treatment choice. For patients underwent STR or with MIB-1 index ≥3%, we hold further radiotherapy is necessary. Close follow-up of the brain and spine for years is crucial to monitor recurrence or metastasis.