Journal of neurosurgery
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Journal of neurosurgery · Sep 2013
Sphenoid sinus anatomy and suprasellar extension of pituitary tumors.
As tumors enlarge, they generally grow along paths of least resistance. For pituitary macroadenomas, extrasellar extension into the suprasellar region, cavernous sinus, or sphenoid sinus may occur. The sphenoid sinus is known to have a variable anatomical configuration, and the authors hypothesize that certain anatomical factors may resist tumor expansion into the sphenoid sinus, thereby directing tumor growth into the suprasellar space. In this paper the authors' goal was to determine if sphenoid anatomy influences pituitary tumor growth. ⋯ Certain aspects of the sphenoid sinus anatomy may function to resist pituitary tumor growth into the sphenoid sinus. Progressive enlargement of pituitary macroadenomas may extend in a suprasellar direction, in part, as a consequence of the sphenoid sinus anatomy.
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Journal of neurosurgery · Sep 2013
Distribution of cerebellar tonsil position: implications for understanding Chiari malformation.
Prior attempts to define normal cerebellar tonsil position have been limited by small numbers of patients precluding analysis of normal distribution by age group. The authors' objective in the present study was to analyze cerebellar tonsil location in every age range. ⋯ Cerebellar tonsil position follows an essentially normal distribution and varies significantly by age. This finding has implications for advancing our understanding of CM.
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Although a number of theoretical and experimental studies dealing with end-to-side neurorrhaphy (ETSN) have been published to date, there is still a considerable lack of clinical trials investigating this technique. Here, the authors describe their experience with ETSN in axillary and musculocutaneous nerve reconstruction in patients with brachial plexus palsy. ⋯ The authors conclude that ETSN should be performed in axillary nerve reconstruction but only when commonly used donor nerves are not available.
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Journal of neurosurgery · Sep 2013
Comparative StudyBiomechanical performance of leather and modern football helmets.
With the increased national concern about concussions in football, recent research has focused on evaluating the impact performance of modern football helmets. Specifically, this technical note offers a biomechanical analysis of classic leather helmets compared with modern helmets. ⋯ The resulting head acceleration was used to assess the risk of concussion for each drop test. The results of this analysis demonstrate that modern helmets are significantly and substantially superior to leather helmets in all impact scenarios, and that notable differences exist among modern helmets.
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Journal of neurosurgery · Sep 2013
Controlled Clinical TrialTransplantation of Schwann cells in a collagen tube for the repair of large, segmental peripheral nerve defects in rats.
Segmental nerve defects pose a daunting clinical challenge, as peripheral nerve injury studies have established that there is a critical nerve gap length for which the distance cannot be successfully bridged with current techniques. Construction of a neural prosthesis filled with Schwann cells (SCs) could provide an alternative treatment to successfully repair these long segmental gaps in the peripheral nervous system. The object of this study was to evaluate the ability of autologous SCs to increase the length at which segmental nerve defects can be bridged using a collagen tube. ⋯ The technique of adding SCs to a guidance channel significantly enhanced the gap distance that can be repaired after peripheral nerve injury with long segmental defects and holds promise in humans. Most importantly, this study represents some of the first essential steps in bringing autologous SC-based therapies to the domain of peripheral nerve injuries with long segmental defects.