Neurosurgery
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Clinical Trial
Partial ipsilateral C7 transfer to the upper trunk for C5-C6 avulsion of the brachial plexus.
Ipsilateral whole C7 root transfer has been reported in treating C5-C6 avulsion. To minimize donor deficits, partial ipsilateral C7 (PIC7) transfer was developed. ⋯ PIC7 transfer, when combined with SAN transfer to SSN as a novel approach, is a safe, easy, and efficacious surgical procedure for patients with simple C5-C6 avulsion.
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Mannitol has traditionally been the mainstay of medical therapy for intracranial hypertension in patients with head injury. We previously demonstrated that mannitol reduces brain volume in patients with cerebral edema, although whether this occurs because of a reduction in brain water, blood volume, or both remains poorly understood. ⋯ A single bolus of 1 g/kg of 20% mannitol does not acutely lower CBV. Another mechanism, such as a reduction in brain water, may better explain mannitol's ability to lower intracranial pressure and reduce mass effect.
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There is no consensus regarding optimal position of an external ventricular drain (EVD) with regard to clearance of intraventricular hemorrhage (IVH). ⋯ It is possible that placement of EVD may be optimized to enhance the clearance of total IVH if lytic agents are used. Catheters on either side can clear the third and fourth ventricles with equal efficiency.
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Case Reports
Long-term results of spinal cord injury therapy using mesenchymal stem cells derived from bone marrow in humans.
Although the transplantation of mesenchymal stem cells (MSCs) after spinal cord injury (SCI) has shown promising results in animals, less is known about the effects of autologous MSCs in human SCI. ⋯ Three of the 10 patients with SCI who were directly injected with autologous MSCs showed improvement in the motor power of the upper extremities and in activities of daily living, as well as significant magnetic resonance imaging and electrophysiological changes during long-term follow-up.
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Clinical Trial
Effectiveness of repeat glycerol rhizotomy in treating recurrent trigeminal neuralgia.
Percutaneous glycerol rhizotomy (GR) is used to treat trigeminal neuralgia (TN), with satisfactory pain relief lasting 2 to 3 years in most patients after the first intervention. The efficacy of subsequent GRs, however, has not been studied. ⋯ TN patients experienced greater pain relief and equivalent durability after GR2+ beyond the initial treatment.