Journal of neurosurgery
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Journal of neurosurgery · Sep 2003
Case ReportsTraumatic carotid-cavernous fistula treated by combined transarterial and transvenous coil embolization and associated cavernous internal carotid artery dissection treated with stent placement. Case report.
The authors report on a case in which a carotid-cavernous fistula and an associated cavernous-carotid dissection developed in a 48-year-old man following a motor vehicle accident. The fistula was treated with coil embolization via a combined transarterial-transvenous approach. The dissected carotid artery segment was treated with a balloon-expandable stent, which restored normal caliber and hemispheric flow. There was no recurrence of the fistula and the postoperative wide patency of the carotid artery indicates that stent placement is an effective method of treating traumatic intracranial artery dissections.
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Journal of neurosurgery · Sep 2003
Differential temporal expression of matrix metalloproteinases after spinal cord injury: relationship to revascularization and wound healing.
Matrix metalloproteinases (MMPs), particularly MMP-9/gelatinase B, promote early inflammation and barrier disruption after spinal cord injury (SCI). Early blockade of MMPs after injury provides neuroprotection and improves motor outcome. There is recent evidence, however, that MMP-9 and MMP-2/gelatinase A participate in later wound healing in the injured cord. The authors therefore examined the activity of these gelatinases during revascularization and glial scar formation in the contused murine spinal cord. ⋯ These findings suggest that although MMP-9 and -2 exhibit overlapping expression during revascularization, the former is associated with acute injury responses and the latter with formation of a glial scar.
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The authors retrospectively reviewed the presenting symptomatology and 6-month outcome in 241 consecutive patients who underwent C6-7 anterior cervical discectomy (ACD) from an overall series of 1008 patients in whom the senior author performed one-level procedures. ⋯ Approximately 15% of patients with a C-7 radiculopathy are likely to present with atypical symptoms that, if persisting after nonsurgical therapy, will often resolve after ACD and fusion.
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Journal of neurosurgery · Sep 2003
Tethering of the spinal cord in mouse fetuses and neonates with spina bifida.
Tethering of the spinal cord is a well-known complication in humans with spina bifida aperta or occulta. Its pathogenesis consists of a pathological fixation of the spinal cord resulting in traction on the neural tissue which, in turn, leads to ischemia and progressive neurological deterioration. Although well established in humans, this phenomenon has not been described in animal models of spina bifida. ⋯ This mouse model provides an opportunity to study the onset and early sequelae of spinal cord tethering in spina bifida.
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Journal of neurosurgery · Sep 2003
Growth factor enhancement of peripheral nerve regeneration through a novel synthetic hydrogel tube.
The authors' long-term goal is repair of peripheral nerve injuries by using synthetic nerve guidance devices that improve both regeneration and functional outcome relative to an autograft. They report the in vitro processing and in vivo application of synthetic hydrogel tubes that are filled with collagen gel impregnated with growth factors. ⋯ The PHEMA-MMA tubes augmented with FGF-1 in their lumens appear to be a promising alternative to autografts for repair of nerve injuries. Studies are in progress to assess the long-term biocompatibility of these implants and to enhance regeneration further.