Neurosurgery
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Vincristine is a commonly used chemotherapeutic agent that results in debilitating untreatable peripheral neuropathy. ⋯ Our data suggest that HIFU increases mechanical and thermal thresholds in VIN rodents. Whether HIFU can preclude the development of reduced thresholds in the VIN model warrants further study.
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Rapid advancement of medical and surgical therapies, coupled with the recent preoccupation with limiting healthcare costs, makes a collision of the 2 objectives imminent. This article explains the value of cost-effectiveness analysis (CEA) in reconciling the 2 competing goals, and provides a brief introduction to evidence-based CEA techniques. The historical role of CEA in determining whether new neurosurgical strategies provide value for cost is summarized briefly, as are the limitations of the technique. Finally, the unique ability of the neurosurgical community to provide input to the CEA process is emphasized, as are the potential risks of leaving these important decisions in the hands of others.
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Chronic deep brain stimulation of the rodent lateral cerebellar nucleus (LCN) has been demonstrated to enhance motor recovery following cortical ischemia. This effect is concurrent with synaptogenesis and expression of long-term potentiation markers in the perilesional cerebral cortex. ⋯ These findings suggest that LCN deep brain stimulation modulates postinjury neurogenesis, providing a possible mechanistic foundation for the associated enhancement in poststroke motor recovery.