Journal of neurosurgery
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Journal of neurosurgery · Sep 2013
Comparative StudyComplement polymorphisms and cognitive dysfunction after carotid endarterectomy.
The role of genetic polymorphisms in the neurological outcome of patients after carotid endarterectomy (CEA) remains unclear. There are single nucleotide polymorphisms (SNPs) that predispose patients to postoperative cognitive dysfunction (CD). We aim to assess the predictability of three complement cascade-related SNPs for CD in patients having CEAs. ⋯ The presence of a deleterious allele in the C5 and CFH SNPs may predispose patients to exhibit CD after CEA. This finding supports previous data demonstrating that the complement cascade system may play an important role in the development of CD. These findings warrant further investigation.
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Journal of neurosurgery · Sep 2013
Case ReportsLimitations of nerve repair of segmental defects using acellular conduits.
The authors present the case of a 20-year-old man who, 3 months after his initial injury, underwent repair of a 1.7-cm defect of the ulnar nerve at the wrist; repair was performed with an acellular nerve allograft. Given the absence of clinical or electrophysiological recovery at 8 months postrepair, the patient underwent reexploration, excision of the "regenerated cable," and rerepair of the ulnar nerve with sural nerve autografts. ⋯ At the 6- and 12-month follow-ups of the sural nerve graft repair, clinical and electrophysiological evidence of both sensory and motor reinnervation of the ulnar nerve and associated hand muscles was demonstrated. In this report, the authors describe a single case of failed acellular nerve allograft and correlate the results with basic science and human studies reporting length and diameter limitations in human nerve repair utilizing grafts or conduits devoid of viable Schwann cells.
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Surgical exposure of a peripheral nerve can be technically challenging, making the operation more extensive and time consuming, particularly in the treatment of small nerves with an anatomically variable position. This study describes the application of ultrasound to facilitate surgical access and localization of targeted peripheral nerves. ⋯ Preoperative ultrasound-guided nerve mapping may be useful in facilitating surgical access to a targeted nerve and thereby minimizing tissue dissection and operating time.
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Journal of neurosurgery · Sep 2013
Biography Historical ArticleCharles Stent and the mystery behind the word "stent".
Stents have come to be well-known devices and are being used widely in numerous branches of medicine. It is intriguing that the word "stent" actually derives from the name of a dentist, Charles Stent, who developed a material to obtain dental impressions. ⋯ Intracranial stenting is a relatively new and rapidly developing field that came into being not more than 12 years ago. The authors describe the life and works of Charles Stent, discuss the possible origins of the word stent, and discuss how intravascular and intracranial stenting came into existence.