Journal of neurosurgery
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Journal of neurosurgery · Jan 2011
Median nerve branches to the pronator teres: cadaveric study with potential use in neurotization procedures to the radial nerve at the elbow.
Various donor nerves have been used for brachial plexus neurotization procedures. To the authors' knowledge, neurotization of median nerve branches to the pronator teres to the radial nerve at the elbow have not been explored. ⋯ Based on the results of our cadaveric study, the use of the branch of the median nerve to the pronator teres muscle may be considered for neurotization of the radial nerve in the cubital fossa.
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Journal of neurosurgery · Jan 2011
High-resolution ultrasonography in the diagnosis and intraoperative management of peripheral nerve lesions.
The diagnosis of peripheral nerve lesions relies on clinical history, physical examination, electrodiagnostic studies, and radiography. Magnetic resonance neurography offers high-resolution visualization of structural peripheral nerve lesions. The availability of MR neurography may be limited, and the costs can be significant. By comparison, ultrasonography is a portable, dynamic, and economic technology. The authors explored the clinical applicability of high-resolution ultrasonography in the preoperative and intraoperative management of peripheral nerve lesions. ⋯ High-resolution ultrasonography may provide an economical and accurate imaging modality with utility in diagnosis and management of peripheral nerve lesions. Further research is required to assess the role of ultrasonography in evaluation of peripheral nerve pathology.
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Journal of neurosurgery · Jan 2011
Review Meta AnalysisMicrovascular decompression for elderly patients with trigeminal neuralgia: a prospective study and systematic review with meta-analysis.
Because the incidence of trigeminal neuralgia (TN) increases with age, neurosurgeons frequently encounter elderly patients with this disorder. Although microvascular decompression (MVD) is the only etiological therapy for TN with the highest initial efficacy and durability of all treatments, it is nonetheless associated with special risks (cerebellar hematoma, cranial nerve injury, stroke, and death) not seen with the commonly performed ablative procedures. Thus, the safety of MVD in the elderly remains a concern. This prospective study and systematic review with meta-analysis was conducted to determine whether MVD is a safe and effective treatment in elderly patients with TN. ⋯ Although patient selection remains important, the authors' experience and the results of this systematic review with meta-analysis suggest that the majority of elderly patients with TN can safely undergo MVD.
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Journal of neurosurgery · Jan 2011
Randomized Controlled TrialSubcutaneous local anesthesia versus intravenous regional anesthesia for endoscopic carpal tunnel release: a randomized controlled trial.
This study compares the effectiveness of subcutaneous infiltration of a local anesthetic agent (LA) versus intravenous regional anesthesia (IVRA) during endoscopic carpal tunnel release. ⋯ Endoscopic carpal tunnel release with subcutaneous infiltration of LA was well tolerated and effective. Injection-associated problems such as increased thickness of the synovial layer or impaired endoscopic view did not occur.