Acta neurologica Belgica
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Acta neurologica Belgica · Mar 2011
Occipital nerve stimulation for intractable chronic cluster headache: new hope for a dreadful disease?
Chronic cluster headache (CCH) is one of the most painful primary headaches. A small percentage of CCH become intractable (iCCH) and is refractory to the majority of preventing drugs. Various invasive and sometimes destructive procedures have been tempted to help these patients, but none gave satisfactory results for the long term. ⋯ Up to now, nearly 38 iCCH patients benefited from ONS in the available literature and the technique appears to give results similar to hDBS, having the advantage to have much milder side effects. The mechanism by which ONS is efficient in iCCH remains unknown but preliminary results of neurophysiological and imaging studies suggest ONS is just a symptomatic treatment which does not act on the disease generator. We would however advocate ONS as first choice alternative therapy in iCCH.
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Acta neurologica Belgica · Mar 2011
The misplacement of external ventricular drain by freehand method in emergent neurosurgery.
External ventricular drain (EVD) placement is one of the most basic and common neurosurgical procedure which most was performed by young neurosurgical trainees. This study is conducted to determinate the safe and accuracy of EVD placement by freehand method. About 129 EVD placements were evaluated in this study. ⋯ The higher misplaced rate was significantly observed in patients whose head CT scans revealed the lower hydrocephalus ratio (28.85%) and the smaller ventricular size (5.6 mm). Twenty-one (16.2%) new hemorrhages associated with EVD placements were observed. Using the freehand method, EVD placement is a safe and effective procedure in management of these emergent neurosurgical diseases.