Journal of neurosurgery
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Journal of neurosurgery · Sep 2013
Safety and pharmacokinetics of sodium nitrite in patients with subarachnoid hemorrhage: a phase IIa study.
Intravenous sodium nitrite has been shown to prevent and reverse cerebral vasospasm in a primate model of subarachnoid hemorrhage (SAH). The present Phase IIA dose-escalation study of sodium nitrite was conducted to determine the compound's safety in humans with aneurysmal SAH and to establish its pharmacokinetics during a 14-day infusion. Methods In 18 patients (3 cohorts of 6 patients each) with SAH from a ruptured cerebral aneurysm, nitrite (3 patients) or saline (3 patients) was infused. Sodium nitrite and saline were delivered intravenously for 14 days, and a dose-escalation scheme was used for the nitrite, with a maximum dose of 64 nmol/kg/min. Sodium nitrite blood levels were frequently sampled and measured using mass spectroscopy, and blood methemoglobin levels were continuously monitored using a pulse oximeter. ⋯ Previous preclinical investigations of sodium nitrite for the prevention and reversal of vasospasm in a primate model of SAH were effective using doses similar to the highest dose examined in the current study (64 nmol/kg/min). Results of the current study suggest that safe and potentially therapeutic levels of nitrite can be achieved and sustained in critically ill patients after SAH from a ruptured cerebral aneurysm.
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Journal of neurosurgery · Sep 2013
Contralateral L-6 nerve root transfer to repair lumbosacral plexus root avulsion: experimental study in rhesus monkeys.
Nerve transfer is used for brachial plexus injuries but has rarely been applied to repairs in the lower extremities. The aim of this study was to evaluate the feasibility and effectiveness of using the contralateral L-6 nerve root to repair lumbosacral plexus root avulsions. ⋯ In this animal model, the contralateral L-6 (analogous to S-1 in humans) nerve root can be used to repair lumbosacral plexus root avulsion.
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Journal of neurosurgery · Sep 2013
Motor function after stereotactic radiosurgery for brain metastases in the region of the motor cortex.
The authors sought to better define the clinical response of patients who underwent stereotactic radiosurgery (SRS) for brain metastases located in the region of the motor cortex. ⋯ Most intact patients with brain metastases in or adjacent to motor cortex maintained neurological function after SRS, and most patients with symptomatic motor weakness remained stable or improved. Larger tumor volumes were associated with less satisfactory outcomes.
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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
Biography Historical ArticleAntonius Balthazar Raymundus Hirsch and the peregrination of "gasserian ganglion".
The anatomical description of the fifth cranial nerve ganglion lacked detail before the work of Antonius Balthazar Raymundus Hirsch (1744-1778). Hirsch used new dissection techniques that resulted in the most meticulous report of the trigeminal ganglion (the gasserian ganglion) to have been reported. In 1765, the 21-year-old published these findings in a thesis, Paris Quinti Nervorum Encephali Disquisitio Anatomica In Quantum Ad Ganglion Sibi Proprium, Semilunare, Et Ad Originem Nervi Intercostalis Pertinet [An anatomical inquiry of the fifth pair of the nerves of the brain, so far as it relates to the ganglion unto itself, the semilunar, and to the source of the intercostal nerve]. ⋯ Oddly, Hirsch died at the young age of 35. For the present paper, the library at the University of Vienna (Universität Wien), Austria, was contacted, and Anton Hirsch's thesis was digitized and subsequently translated from Latin into English. The authors here attempt to place the recognition of the fifth cranial nerve ganglion within a historical perspective and trace the trajectory of its anatomical descriptions.