Neurosurgery
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Fixed dystonic postures secondary to ischemic, traumatic, or postsurgical lesions located in the basal ganglia and brainstem constitute a major therapeutic challenge and limit motor rehabilitation efficacy. They are often refractory to conservative treatment. Aberrant cerebral plasticity developed after deep brain lesions is thought to lead to abnormal cortical representation of the affected part of the body and then to pathological fixed postures. ⋯ Although the pathophysiology of fixed dystonia is unknown, our results suggest a major role of the motor cortex in this condition and reinforce the hypothesis that postlesional delayed cortical rearrangements might take place in these forms and be the target of effective therapeutic neuromodulation.
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Folate receptor alpha (FRα) plays a pivotal role in the tumorigenesis of some malignant tumors, but its role and clinical significance in pituitary adenomas remain unclear. ⋯ FRα may play an important role in the development and progression of NFAs. Therefore, FRα may be useful as a molecular biomarker for the diagnosis of NFAs and assessment of tumor invasiveness.
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Case Reports
Pathologically confirmed cryptic vascular malformation as a cause of convexity subarachnoid hemorrhage: case report.
We report a rare case of pathologically confirmed cryptic vascular malformation as a cause of primary convexity subarachnoid hemorrhage (SAH) of unknown etiology. ⋯ It is important to consider the possibility of ruptured cryptic vascular malformation as a cause of nontraumatic nonaneurysmal convexity SAH when recurrent hemorrhage occurs despite thorough diagnostic workup, because surgical resection may be the only curative treatment option to eliminate the risk of rebleeding and disabling symptoms.
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Somatosensory evoked potential (SSEP) monitoring is used during intracranial aneurysm surgery to track the effects of anesthesia, surgical manipulation, and temporary clipping. ⋯ Intraoperative SSEP changes are more reliable in unruptured aneurysm cases than in ruptured cases. Whereas irreversible changes in unruptured cases were associated with an 80% stroke rate, such changes in ruptured cases did not have any adverse ischemic sequelae in 58% of patients. This information is helpful during the intraoperative assessment of reported SSEP changes.