Neurosurgery
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To better understand the presentation, management, and outcome of syringobulbia in the pediatric age group. ⋯ Syringobulbia is strongly associated with Chiari malformation and syringomyelia, and patients often present because of cranial nerve palsies. Posterior fossa decompression is a safe and effective treatment.
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There are few large-volume studies of the repair of complete missile-caused peroneal nerve and peroneal division lesions. In this prospective study, the outcomes of such repairs are studied and the factors influencing the outcomes are analyzed. ⋯ After peroneal nerve or peroneal division repairs, a successful outcome is most probable with low-level lesions repaired in the first 3 months after injury using grafts smaller than 4 cm. Conversely, high-level repairs delayed for more than 7 months after injury and using grafts larger than 8 cm are probably not worthwhile.
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Pulsatile tinnitus is characterized by hearing the heart beat or respiration in one or both ears. In 15% of patients with pulsatile tinnitus, no cause can be found. Other investigators have suggested that a vascular loop entering the internal auditory meatus can be another cause of arterial, pulse synchronous tinnitus. If so, we should constantly hear the arterial pulsations of the carotid arteries passing through the petrous bone. ⋯ Vascular loops in the internal auditory canal may generate pulsatile tinnitus. It may be treated by placing Teflon between the cochlea and the intrameatal vascular loop. One then does not hear the pulsation of the carotids due to a dampening effect of a pericarotid venous plexus.
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Epidermal growth factor (EGF) and fibroblast growth factor-2 (FGF-2) play a critical role in neurogenesis. In the present study, we evaluated the additive effect of administering these two factors on post-ischemic progenitor cell proliferation, survival, and phenotypic maturation in the hippocampal dentate gyrus (DG) and the subventricular zone (SVZ) in the adult rat brain after transient middle cerebral artery occlusion. ⋯ Specific growth factor infusion enhances post-ischemic progenitor cell proliferation by 5 days of reperfusion and neuronal maturation by 21 days of reperfusion in both the DG and SVZ in the adult rat brain.
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Case Reports
Isolated abducent nerve palsy after microvascular decompression for trigeminal neuralgia: case report.
Microvascular decompression (MVD) is a safe and effective treatment for trigeminal neuralgia. Isolated postoperative ipsilateral abducent nerve palsy is an extremely rare complication of this procedure and has not been reported before. The author wishes to report this rare complication, discuss its aetio-pathogenesis and the natural course. ⋯ Isolated abducent nerve damage is a rare complication of the MVD procedure. Surgical manipulation of the dilated and tortuous vessels located anterior to the trigeminal nerve may cause indirect stretching of the delicate abducent nerve with resultant neuropraxia. This complication is difficult to recognize and prevent intra-operatively as the nerve lies on the far side of the artery. Fortunately, spontaneous recovery of the neural function seems to be the most likely outcome.