Neurosurgery
-
Tinnitus is predominantly viewed as the consequence of dysfunctional hyperactivity, plastic change, or synchronized oscillations in the central auditory system. An alternative to the current auditory-centric view of auditory phantom perception is the basal ganglia-centric view. Recent electrical stimulation experiments in area LC, a locus of the caudate nucleus positioned at its anterior body, has shown loudness modulation of existing tinnitus percepts. ⋯ Neuromodulation of area LC can trigger temporary gate dysfunction and reversibly release new phantoms for conscious awareness. Restoration of restrictive dorsal striatal gate function to treat problematic phantom percepts may be realized by adopting long-term area LC neuromodulation and choosing optimal stimulation parameters.
-
Many studies address diagnosing concussions, but few look at predicting prognosis. A previous discriminant function analysis showed that symptom clusters derived from the Post-Concussion Symptom Scale and Immediate Postconcussion Assessment and Cognitive Testing composite scores used together improved predictions of protracted recovery after a sports-related concussion. ⋯ Specific cutoffs may help to set numerical thresholds for clinicians to predict which concussed athletes will have a protracted recovery.
-
Outcome of lumbar disc herniation is often based on clinical scores and less frequently on the neurological examination. However, even when clinical outcome measures are favorable, patients may still experience motor or sensory impairment. ⋯ There seems to be no correlation between clinical results and neurological impairment when assessed by the VAS and ODI.
-
Restoration of elbow extension has not been considered of much importance regarding functional outcomes in brachial plexus surgery; however, the flexion of the elbow joint is only fully effective if the motion can be stabilized, what can be achieved solely if the triceps brachii is coactivated. To present a novel nerve transfer of a healthy motor fascicle from the ulnar nerve to the nerve of the long head of the triceps to restore the elbow extension function in brachial plexus injuries involving the upper and middle trunks. ⋯ The attempted nerve transfer was effective for restoration of elbow extension in primary brachial plexus surgery; however, it should be selected only for cases in which other reliable donor nerves were used to restore elbow flexion.
-
Biography Historical Article
Maister Peter Lowe and his 16th century contributions to cranial surgery.
Before the advent of neurosurgery as a discipline, various historic surgeons performed procedures on the skull and brain. One early pioneer of surgery, Peter Lowe (c. 1550-1612), not only wrote of methods of cranial surgery in his Chirurgerie, which was the first comprehensive text of surgery written in English, but also founded what would become the Royal Faculty of Physicians and Surgeons. ⋯ This 16th century Scottish surgeon trained in Paris, where he was influenced by Ambroise Paré and wrote about the "Spanish sickness." In his surgical text, Lowe wrote about his methods of multiple neurosurgical procedures. The present study discusses the life of Maister Peter Lowe and reviews his contributions to what became the art of neurosurgery.