Journal of neurosurgery
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Journal of neurosurgery · Jan 2005
Case ReportsNerve reconstruction in lumbosacral plexopathy. Case report and review of the literature.
Neurological injury to the lumbosacral plexus associated with pelvic and sacral fractures has traditionally been treated conservatively, despite significant and often debilitating functional deficits of the lower extremities. The authors report a case of reconstruction of the lumbosacral plexus, including nerve grafting to restore lower-extremity function caused by severe trauma to the pelvis. A 16-year-old boy sustained pelvic and sacral fractures in a motor vehicle accident. ⋯ After 2.5 years, he experienced reinnervation of his gluteal and hamstring muscles and could perceive vibration on the sole of his foot. With the assistance of a foot-drop splint, the patient ambulates well and is able to ski. Operative details and the relevant literature are reviewed.
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Journal of neurosurgery · Jan 2005
Targeting the cranial nerve: microradiosurgery for trigeminal neuralgia with CISS and 3D-flash MR imaging sequences.
The authors undertook a study to identify magnetic resonance (MR) imaging techniques that can be used reliably during gamma knife surgery (GKS) to identify the trigeminal nerve, surrounding vasculature, and areas of compression. ⋯ The CISS/3D-Flash fusion imaging has become the preferred imaging method at the authors' institutions during GKS for trigeminal neuralgia. It affords the best visualization of the trigeminal nerve, surrounding vasculature, and the precise location of vascular compression.
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Journal of neurosurgery · Jan 2005
Real-time in vivo imaging of the convective distribution of a low-molecular-weight tracer.
Convection-enhanced delivery (CED) is increasingly used to distribute therapeutic agents to locations in the central nervous system. The optimal application of convective distribution of various agents requires the development of imaging tracers to monitor CED in vivo in real time. The authors examined the safety and utility of an iodine-based low-molecular-weight surrogate tracer for computerized tomography (CT) scanning during CED. ⋯ Real-time in vivo CT scanning of CED of iopamidol appears to be safe, feasible, and suitable for monitoring convective delivery of drugs with certain features and low infusion volumes.
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Journal of neurosurgery · Jan 2005
Tumor recurrence and survival following gamma knife surgery for brain metastases.
The authors evaluated prognostic factors for tumor recurrence and patient survival following gamma knife surgery (GKS) for brain metastasis. ⋯ Recurrence rates of brain metastasis following GKS are related to duration of survival, which is in turn mostly dependent on the nature and course of the primary tumor.
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Journal of neurosurgery · Jan 2005
Risk factors for aneurysmal subarachnoid hemorrhage in patients in Izumo City, Japan.
The annual incidence of aneurysmal subarachnoid hemorrhage (SAH) in Izumo City, Japan, appears to be the highest rate among those reported; therefore the author investigated the risk factors for SAH in patients in this city. ⋯ Among patients in Izumo, hypertension was the most notable risk factor for aneurysmal SAH, regardlessof age and sex, followed by cigarette smoking in younger men and hypercholesterolemia in older women. In older women, diabetes mellitus and heart disease decreased the risk of SAH.