Journal of neurosurgery
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Journal of neurosurgery · Apr 2013
Predictors of cranioplasty complications in stroke and trauma patients.
Decompressive craniectomy mandates subsequent cranioplasty. Complications of cranioplasty may be independent of the initial craniectomy, or they may be contingent upon the craniectomy. Authors of this study aimed to identify surgery- and patient-specific risk factors related to the development of surgical site infection and other complications following cranioplasty. ⋯ Cranioplasty complications are common. Cranioplasty infection rates are predicted by reoperation following craniectomy and therapeutic indication (stroke). These variables may be associated with patient-centered risk factors that increase cranioplasty infection risk.
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Journal of neurosurgery · Apr 2013
Biography Historical ArticleThe lucid interval associated with epidural bleeding: evolving understanding.
The aim of this paper was to elucidate the evolution of our understanding of the term "lucid interval." A number of texts were reviewed to assess their suitability for analysis. The primary requirement was that the text contain detailed descriptions of a series of patients. Details of the clinical course, the findings and timing of surgery, and, when relevant, the time of death and postmortem findings were required. ⋯ The first to have a proper understanding of the interval in relation to an EDH was John Abernethy. The modern description and definition of the lucid interval was the work of Hutchinson and Jacobson in the latter half of the 19th century. Understanding of the pathophysiology of the lucid interval has been advanced by the work of Ford and McLaurin in Cincinnati and a group in Oslo, with the demonstration of what it takes to loosen dura and how an arteriovenous shunt slows down for a while the accumulation of an EDH.
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Journal of neurosurgery · Apr 2013
Incidence of high-frequency hearing loss after microvascular decompression for hemifacial spasm.
The primary aim of this study was to evaluate the incidence and discuss the pathogenesis of high-frequency hearing loss (HFHL) after microvascular decompression (MVD) for hemifacial spasm (HFS). ⋯ High-frequency hearing loss occurs in a significant number of patients following MVD surgery for HFS. Drill-induced noise and transient loss of CSF during surgery may impair hearing in the high-frequency ranges on both the ipsilateral and contralateral sides, with the ipsilateral side being more affected. Changes in intraoperative BAEPs during MVD for HFS were not useful in predicting HFHL. Follow-up studies and repeat audiological examinations may be helpful in evaluating the time course and prognosis of HFHL. Prospective studies focusing on decreasing intraoperative noise exposure, as well as auditory shielding devices, will establish causation and allow the team to intervene appropriately to decrease the risk of HFHL.
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Journal of neurosurgery · Apr 2013
Enhanced antitumor effect of YM872 and AG1296 combination treatment on human glioblastoma xenograft models.
Blockade of Ca(++)-permeable α-amino-3-hydroxy-5-methyl-4-isoxazolepropionate receptor (AMPAR) inhibits the proliferation of human glioblastoma by inhibiting Akt phosphorylation, which is independent of the phosphatidylinositol 3-kinase pathway. Inhibiting platelet-derived growth factor receptor (PDGFR)-mediated phosphorylation causes growth inhibition in glioblastoma cells. The authors of this study investigated the effects of YM872 and AG1296, singly and in combination and targeting different pathways upstream of Akt, on Akt-mediated tumor growth in glioblastoma cells in vivo and in vitro. ⋯ The strongly enhanced antitumor effect of this combination therapy in vivo rather than in vitro may be attributable to disruption of the aberrant vascular niche. This combination therapy might provide substantial benefits to patients with glioblastoma.
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Journal of neurosurgery · Apr 2013
Inhibition of glioblastoma and enhancement of survival via the use of mibefradil in conjunction with radiosurgery.
The survival of patients with high-grade gliomas remains unfavorable. Mibefradil, a T-type calcium channel inhibitor capable of synchronizing dividing cells at the G1 phase, has demonstrated potential benefit in conjunction with chemotherapeutic agents for gliomas in in vitro studies. In vivo study of mibefradil and radiosurgery is lacking. The authors used an intracranial C6 glioma model in rats to study tumor response to mibefradil and radiosurgery. ⋯ Mibefradil response is schedule dependent and enhances survival and reduces glioblastoma when combined with ionizing radiation.