Journal of neurosurgery
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Journal of neurosurgery · May 2008
Cerebral oxygenation, vascular reactivity, and neurochemistry following decompressive craniectomy for severe traumatic brain injury.
This study addresses the changes in brain oxygenation, cerebrovascular reactivity, and cerebral neurochemistry in patients following decompressive craniectomy for the control of elevated intracranial pressure (ICP) after severe traumatic brain injury (TBI). ⋯ Decompressive craniectomy, when used appropriately in protocol-driven intensive care regimens for the treatment of recalcitrant elevated ICP, is associated with a return of abnormal metabolic parameters to normal values in patients with eventually favorable outcomes.
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Journal of neurosurgery · May 2008
Honoring the 75th anniversary of the American Association of Neurological Surgeons.
Ever since the Journal of Neurosurgery (JNS) published its first volume in 1944, the journal has reflected the scientific, technical, and clinical evolution of our specialty and parent organization, first called the Harvey Cushing Society and later the American Association of Neurological Surgeons. The JNS has been an uncompromising arbiter of progress in our specialty, and its superb editorial stewardship has led to its recognition as the premier journal in the field. ⋯ We hope you will enjoy these articles and the accompanying commentaries. In this issue we present the next paper in this series.
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Journal of neurosurgery · May 2008
Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture.
The authors conducted a study to investigate the long-term natural history of unruptured intracranial aneurysms and the predictive risk factors determining subsequent rupture in a patient population in which surgical selection of cases was not performed. ⋯ Cigarette smoking, size of the unruptured intracranial aneurysm, and age, inversely, are important factors determining risk for subsequent aneurysm rupture. The authors conclude that such unruptured aneurysms should be surgically treated regardless of their size and of a patient's smoking status, especially in young and middle-aged adults, if this is technically possible and if the patient's concurrent diseases are not contraindications. Cessation of smoking may also be a good alternative to surgery in older patients with small-sized aneurysms.
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Journal of neurosurgery · May 2008
Case ReportsFailure of long-term nerve root stimulation to improve neuropathic pain.
Stimulation of dorsal nerve roots or dorsal root ganglia was reported to alleviate neuropathic pain in selected patients during the early postoperative period. A prospective study was initiated to investigate long-term outcome in patients with neuropathic pain of the lower extremities or groin who were treated with selective nerve root stimulation. ⋯ Spinal nerve root stimulation proved to be effective on short-term follow-up in 3 patients with neuropathic pain in a dermatomal distribution. Long-term stimulation, however, was disappointing because of the loss of effectiveness and the occurrence of side effects.