Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Sep 2015
Case ReportsSporadic lower motor neuron disease with a snake eyes appearance on the cervical anterior horns by MRI.
Lower motor neuron disease (LMND) is the term generally used to describe diseases in which only lower motor neuron signs are detected. A snake eyes appearance on magnetic resonance imaging (MRI) is associated with a wide spectrum of neurological conditions including LMND. The author reports on three unique LMND patients with upper limb muscle weakness and atrophy who show a snake eyes appearance by MRI. ⋯ These patients should be classified as sporadic LMND with snake eyes on MRI with a relatively benign prognosis.
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Clin Neurol Neurosurg · Sep 2015
Assessment of quantitative corticospinal tract diffusion changes in patients affected by subcortical gliomas using common available navigation software.
The aim of this study is to analyze the quantitative DTI parameters of the CST in patients suffering from subcortical gliomas affecting the CST using generally available navigation software. ⋯ The present study has demonstrated for the first time a significant difference of DTI based quantitative parameters of the CST between a tumor affected and a non-affected hemisphere in patients with a corresponding motor deficit. This preliminary data suggests a correlation between DTI based integrity of CST and its function.
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Clin Neurol Neurosurg · Aug 2015
The bigger, the better? About the size of decompressive hemicraniectomies.
Decompressive hemicraniectomy (DHC) is a treatment option in refractory ICP elevation and malignant infarction. A minimum diameter of 12 cm has been widely accepted as mandatory for effective decompression for ICP control. Complete hemispheric exposure is frequently advocated to further reduce the risk of parenchymal shear stress, hemorrhage and swelling. At the same time, superior efficacy and comparable risk profile of a more extensive decompression have yet to be established. ⋯ Due to the heterogeneity of underlying disease, a conclusion as to effect of craniectomy size on long-term outcome cannot be made based on this study. However, if the obligatory lower threshold of 12 cm for DHC size and decompression to the temporal base are observed, a smaller craniectomy is equally effective in relieving intracranial hypertension. While not inadvertently associated with a more favorable surgical risk profile, it does not increase the risk for early secondary complications such as parenchymal shear stress, hemorrhage and swelling.
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Clin Neurol Neurosurg · Aug 2015
Clinical study of C3-C4 level surgical cases of cervical spondylosis.
The purpose of this study was to elucidate the pathological characteristics of C3-C4 cervical spondylotic myelopathy (CSM). ⋯ In C3-C4 ACDF patients, not only static factors, but dynamic factors (instability) at the C3-C4 level contributed to the major causes of CSM.