Neurosurgery
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Intracranial dural arteriovenous fistulas (DAVFs) are acquired abnormal communications between dural arteries and veins. Risk factors for development include sinus thrombosis and hypercoagulability, such as occurs in heritable thrombophilias. While there have been reports of other types of vascular anomalies (such as cavernous and arteriovenous malformations) occurring in families, to our knowledge there have been no reports of familial intracranial DAVFs. We describe the first 2 cases of intracranial DAVFs occurring in first-degree relatives. ⋯ We describe 2 sisters who were heterozygous for Prothrombin G20210A mutation and found to have DAVFs. Clinicians should be aware of the potential for these fistulas to congregate in first-degree relatives via heritable thrombophilias such as the Prothrombin G20210A mutation.
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Although deep brain (DBS) and transcranial direct current stimulation (tDCS) are used as investigative tools and therapies for a variety of neurological and psychiatric conditions, their mechanisms of action remain poorly understood. Therefore, there is a need for new animal models of neuromodulation. ⋯ Our results show DC-DBS-induced reductions in slow-wave activity consistent with recent tDCS studies. We propose that this model will provide a means to explore basic mechanisms of neuromodulation and could facilitate future application of DC-DBS in humans.
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Spinal metastases of the second cervical vertebra are a subset of tumors that are particularly difficult to address surgically. Previously described techniques require highly morbid circumferential dissection posterior to the pharynx for resection and reconstruction. ⋯ When C1 lateral mass to C3 facet bilateral cage plus occipitocervical instrumentation is compared with existing anterior and posterior constructs, this novel reconstruction is biomechanically equivalent if not superior in performance. In a patient, the posterior-only approach for C2 spondylectomy with the novel reconstruction was safe and durable and avoided the morbidity of the anterior approach.
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Multicenter Study
Culture of olfactory ensheathing cells for central nerve repair: the limitations and potential of endoscopic olfactory mucosal biopsy.
Autotransplantation of olfactory ensheathing cells (OECs) into the damaged central nervous system is a potential therapeutic strategy for spinal cord and root cord injuries. One limiting factor has been the poor OEC yields from human mucosal biopsies. Previous studies have only commented on their success in obtaining mucosal specimens containing olfactory mucosa, but have not commented on the yield of OECs from those specimens. ⋯ We have provided evidence that biopsies closer to the cribriform plate can produce larger yields of OECs, and that patient factors like age and mucosal disease adversely affect the culture yield.