Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2016
Time course of cerebrospinal fluid inflammatory biomarkers and relationship to 6-month neurologic outcome in adult severe traumatic brain injury.
Activation of the inflammatory cascade is a known pathophysiologic process in severe traumatic brain injury (TBI) with yet non-standardized scientific data regarding relationship to outcome. The understanding of the time course of expression of cerebrospinal fluid (CSF) biomarker levels following severe TBI is an important step toward using these biomarkers to measure injury severity and/or early response to therapeutic interventions. The objective of the current study is to report the time course and values of a battery of CSF inflammatory biomarkers following severe TBI in our reasonably sized patient cohort. ⋯ The study shows that inflammatory biomarkers in CSF are potential biomarkers of injury severity and progression and/or recovery; they could prove beneficial in the future assessment of injury severity and response to therapy after severe TBI.
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Clin Neurol Neurosurg · Oct 2016
Benefits of subthalamic stimulation for elderly parkinsonian patients aged 70 years or older.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an accepted treatment for advanced Parkinson disease (PD). However, there is general reluctance in considering this therapy for PD patients over age 70 years with limited supporting evidence. Present study investigates age impacts in STN-DBS outcomes, focusing particularly on the elderly patients. ⋯ STN-DBS therapy is beneficial to some elderly PD patients aged 70 years or older. Tremor, axial dysfunctions and drug-induced dyskinesia are the main indications for the elderly; however, their clinical benefits are inferior to those of younger patients.
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Clin Neurol Neurosurg · Sep 2016
Review Meta AnalysisTransoral and transnasal odontoidectomy complications: A systematic review and meta-analysis.
The craniovertebral junction (CVJ) is a complex region of the spine with unique anatomical and functional relationships. To alleviate symptoms associated with pathological processes involving the odontoid process, decompression is often required, including odontoidectomy. Accurate knowledge of the complication rates following the transoral and transnasal techniques is essential for both patients and surgeons. ⋯ This work presents a systematic review of complications reported for transoral or transnasal odontoidectomy across a heterogeneous group of surgeons and patients. Due to inconsistent reporting, statistical significance was only achieved for postoperative tracheostomy, which was significantly higher in the transoral group. This investigation sets the framework for further discussions regarding odontoidectomy approach options and their associated complications during the informed consent process.
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Clin Neurol Neurosurg · Sep 2016
An investigation on the effect of improved X-rays-guided radiofrequency thermocoagulation denervation on lumbar facet joint syndrome.
This study aims to observe the clinical efficacy and feasibility of improved X-rays-guided radiofrequency thermocoagulation denervation for treating low back pain secondary to lumbar facet joint syndrome (LFJS). ⋯ Improved X-rays-guided radiofrequency thermocoagulation denervation is an effective, minimally invasive and convenient method for treating low back pain secondary to lumbar facet syndrome.
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Clin Neurol Neurosurg · Aug 2016
Transforaminal percutaneous endoscopic lumbar discectomy for very high-grade migrated disc herniation.
Transforaminal percutaneous endoscopic lumbar discectomy (PELD) for high-grade migrated disc herniation has been regarded as a challenging task, but because of the remarkable improvement in navigable instruments and advanced epiduroscopic technique, it can be used for the treatment of high- or very high-grade migrated disc herniation. The purpose of this study was to describe in detail the standardized technique of transforaminal PELD for very high-grade migrated disc herniation and demonstrate the clinical results. ⋯ Transforaminal PELD can be effective for very high-grade migrated lumbar disc herniation, and a standardized technique may provide a reliable and reproducible result.