Journal of neurosurgery
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Journal of neurosurgery · Feb 2009
Comparative StudyPrognostic value of globus pallidus internus volume in primary dystonia treated by deep brain stimulation.
Given that improvement is variable from one patient to another, the authors analyzed the impact of globus pallidus internus (GPi) volume on the result of deep brain stimulation (DBS) by comparing highly and less improved patients with primary dystonodyskinetic syndromes. ⋯ On the left side, the mean stimulated volumes (isofield line range 0.2-1 V/mm) were significantly larger in highly improved than in less improved patients. In this model, the threshold for functional effect was calculated at 0.2 V/mm.
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Journal of neurosurgery · Feb 2009
Prognostic factors in the persistence of posttraumatic epilepsy after penetrating head injuries sustained in war.
The goal of this paper was to investigate the long-term outcome and the possible prognostic factors that might have influenced the persistence of posttraumatic epilepsy after penetrating head injuries sustained during the Iraq-Iran war (1980-1988). ⋯ Early seizures, prophylactic antiepileptics drugs, and surgical intervention did not significantly affect long-term outcome in regard to persistence of seizures.
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Pituitary stalk hemangioblastomas are rare, and information on them is limited to a small number of case reports. To gain insight into the incidence, clinical effects, and management of pituitary stalk hemangioblastomas, the authors analyzed a series of patients with von Hippel-Lindau (VHL) disease. ⋯ The pituitary stalk is the most common site for the development of supratentorial hemangioblastomas in patients with VHL disease. Pituitary stalk hemangioblastomas often remain asymptomatic and do not require treatment. These findings indicate that pituitary stalk hemangioblastomas in patients with VHL disease may be managed with observation and that surgery for them can be reserved until associated signs or symptoms occur.
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Journal of neurosurgery · Feb 2009
Comparative StudyInfection following deep brain stimulator implantation performed in the conventional versus magnetic resonance imaging-equipped operating room.
Risk factors for deep brain stimulator (DBS) infection are poorly defined. Because DBS implants are not frequently performed in the MR imaging-equipped operating room (OR), no specific data about infection of DBS implants performed in the MR imaging environment are available in the literature. In this study the authors focus on the incidence of infection in patients undergoing surgery in the conventional versus MR imaging-equipped OR. ⋯ Infection is a serious complication of DBS implantation and commonly requires device removal for cure. The authors found that DBS implantation can be safely performed in MR imaging-equipped suites, possibly allowing improved lead placement. Young age was associated with an increased risk of DBS infection.
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Journal of neurosurgery · Feb 2009
Biography Historical ArticleWilliam S. Halsted and Harvey W. Cushing: reflections on their complex association.
William Stewart Halsted, the father of modern surgery, and Harvey Williams Cushing, the father of neurosurgery, are remembered for their countless innovations and contributions to the discipline of surgery. Between 1896 and 1912, they worked together at Johns Hopkins Hospital making many of their respective achievements possible. In the later years, their complex relationship, somewhat strained during Cushing's residency, grew into a mutual respect and deep appreciation for one another. In this offering, the authors attempt to elucidate the evolution of this complex relationship.