Journal of neurosurgery
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Journal of neurosurgery · Feb 2014
Assessment of the rate of spinal motor axon regeneration by choline acetyltransferase immunohistochemistry following sciatic nerve crush injury in mice.
The purpose of this study was to examine whether choline acetyltransferase (ChAT) staining can be used for assessing the rate of motor neuron regeneration at an early phase of axon outgrowth. ⋯ Our results suggest that measuring the length of motor axon outgrowth by ChAT immunostaining is reliable. ChAT staining provides a more convenient method for evaluating the rate of motor axon outgrowth in a mixed nerve.
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Journal of neurosurgery · Feb 2014
Value-based neurosurgery: the example of microvascular decompression surgery.
Value of care is emerging as a promising framework to restructure health care, emphasizing the importance of reporting multiple outcomes that encompass the entire care episode instead of isolated outcomes specific to care points during a patient's care. The authors assessed the impact of coordinated implementation of processes across the episode of surgical care on value of neurosurgical care, using microvascular decompression (MVD) as an example. ⋯ Comprehensive implementation of improvement processes throughout the continuum of care resulted in improved global outcome and greater value of delivered care. Enhanced-recovery perioperative protocols and diagnosis-specific clinical pathways are two avenues built around global care delivery that can help achieve an "optimal episode of surgical care" in every case.
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Journal of neurosurgery · Feb 2014
The influence of dynamic response and brain deformation metrics on the occurrence of subdural hematoma in different regions of the brain.
The purpose of this study was to examine how the dynamic response and brain deformation of the head and brain-representing a series of injury reconstructions of which subdural hematoma (SDH) was the outcome-influence the location of the lesion in the lobes of the brain. ⋯ The results indicated that there are differences in magnitude for rotational acceleration and brain deformation metrics that may identify the location of SDH in the brain.
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Journal of neurosurgery · Feb 2014
Smooth-muscle progenitor cells isolated from patients with moyamoya disease: novel experimental cell model.
Moyamoya disease (MMD) is a cerebrovascular occlusive disease affecting bilateral internal carotid termini. Smooth-muscle cells are one of the major cell types involved in this disease process. The characteristics of circulating smooth-muscle progenitor cells (SPCs) in MMD are poorly understood. The authors purified SPCs from the peripheral blood of patients with MMD and sought to identify differentially expressed genes (DEGs) in SPCs from these patients. ⋯ With adequate culture conditions, SPCs could be established from the peripheral blood of patients with MMD. These cells showed specific DEGs compared with healthy control volunteers. This study provides a novel experimental cell model for further research of MMD.
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Journal of neurosurgery · Feb 2014
Case ReportsIncidence of cranial nerve palsy after preoperative embolization of glomus jugulare tumors using Onyx.
The resection of glomus jugulare tumors can be challenging because of their inherent vascularity. Preoperative embolization has been advocated as a means of reducing operative times, blood loss, and surgical complications. However, the incidence of cranial neuropathy associated with the embolization of these tumors has not been established. The authors of this study describe their experience with cranial neuropathy following transarterial embolization of glomus jugulare tumors using ethylene vinyl alcohol (Onyx, eV3 Inc.). ⋯ Embolizing glomus jugulare tumors with Onyx can produce a dramatic reduction in tumor vascularity. However, the intimate anatomical relationship and overlapping blood supply between these tumors and cranial nerves may contribute to a high incidence of cranial neuropathy following Onyx embolization.