Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · May 2015
Surgical treatment for cervical spondylotic myelopathy in elderly patients: a retrospective study.
To analyze perioperetive clinical features and outcomes of surgical treatment for cervical spondylotic myelopathy (CSM) in elderly patients. ⋯ Elderly patients with CSM present long period and serious symptoms, and the degeneration of multiple organs. Surgical decompression for CSM appears to be a beneficial and safe procedure for older patients if properly handled, although the recovery rate is poorer than that of younger patients.
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Clin Neurol Neurosurg · May 2015
Migraine features in migraineurs with and without anxiety-depression symptoms: a hospital-based study.
Migraine, anxiety and depression often coexist. A "neurolimbic" model of migraine has been recently proposed accounting for a dynamic influence of pain, mood and anxiety on the migraine disease. However, very few data exist concerning clinical migraine features in patients reporting anxiety-depression symptoms. ⋯ Our results showed that the presence of anxiety-depression symptoms affects migraine clinical presentation. They are associated with enhanced migraine triggers susceptibility, more ictal allodynic symptoms as well as more headaches/month. An altered sensation in migraineurs with anxiety-depression symptoms could be a result of a lower pain threshold and an increased cortical excitability in a broader context of a neurolimbic dysfunction.
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Clin Neurol Neurosurg · May 2015
Crossing Y-stent technique with dual open-cell stents for coiling of wide-necked bifurcation aneurysms.
Double stenting in a Y-configuration is a promising therapeutic option for wide-necked cerebral aneurysms not amenable to reconstruction with a single stent. We retrospectively evaluated the efficacy and safety of the crossing Y-stent technique for coiling of wide-necked bifurcation aneurysms. ⋯ In this report on 20 patients, crossing Y-stent technique for coiling of wide-necked bifurcation aneurysms showed a good technical safety and favorable clinical and angiographic outcome.
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Clin Neurol Neurosurg · May 2015
Does CT wand guidance improve shunt placement in patients with hydrocephalus?
To evaluate the effectiveness of stereotactic navigation in enhancing the accuracy of ventricular shunt placement in patients with hydrocephalus. ⋯ CT guided navigation did not significantly improve the accuracy of ventricular shunt placement in adults with hydrocephalus for an experienced surgeon. Further studies are required to assess the utility of CT guided navigation for less experienced surgeons and patients with small or dysmorphic ventricles.
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Clin Neurol Neurosurg · May 2015
The endoscopic endonasal approach for cerebrospinal fluid leak repair in the elderly.
Cerebrospinal fluid (CSF) rhinorrhea can lead to CNS infections, carrying significant morbidity and mortality, especially in the elderly. Endoscopic endonasal surgery is a validated technique in the repair of anterior skull base CSF leaks. The aim of this study is to assess diagnostic management, surgical technique and clinical outcome in a consecutive series of elderly patients. ⋯ Endoscopic endonasal surgery is a minimally invasive procedure for CSF leak treatment. In our experience, IF injection proved safe and efficient in detecting skull base defects not identified by preoperative imaging. Endoscopic endonasal surgery proved effective and reliable also in elderly patients, with short hospitalization times and no morbidity.