Neurosurgery
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Clinical Trial
Cranioplasty with adipose-derived stem cells and biomaterial: a novel method for cranial reconstruction.
There is no optimal method for reconstruction of large calvarial defects. Because of the limitations of autologous bone grafts and alloplastic materials, new methods for performing cranioplasties are needed. ⋯ The combination of scaffold material such as beta-tricalcium phosphate and autologous adipose-derived stem cells constitutes a promising model for reconstruction of human large cranial defects. The success of these clinical cases paves way for further studies and clinical applications to turn this method into a reliable treatment regimen.
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The availability of markers able to provide an early insight related to prognostic and functional outcome of patients with traumatic brain injury (TBI) are limited. ⋯ Early elevations (up to 3 days) of S100B and NSE secondary to severe TBI predict deterioration to brain death. However, this feature was more prominently associated with NSE than S100B.
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Cerebral vasospasm (CV) is a potentially disastrous consequence of subarachnoid hemorrhage despite medical treatment. Nimodipine is a potent drug for vessel relaxation, but side effects may preclude a sufficient dose. ⋯ Preliminary data show that CLINA is a straightforward, effective, and safe option for patients with severe CV refractory to medical therapy. Dilation of spastic arteries starts within a few hours and is lasting. Indication for CLINA is peripheral and diffuse CV at any location.
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One of the least remembered eponyms associated with Harvey Cushing is "Cushing's ulcer." The basis of this credit is a paper published in 1932 in which Cushing describes patients who postoperatively and unexpectedly died of perforated peptic ulcers. It is one of the first descriptions of a stress ulcer and a treatise on the brain-stomach connection. Harvey Cushing was puzzled by the pathogenesis of these peptic ulcerations and perforations and advanced several theories. ⋯ It is ironic that Harvey Cushing, in his later years with failing health, developed an ulcer himself. Cushing noted in his correspondence that he felt the agitation over this newspaper clipping caused his later ulcer. The first description of a neurogenic ulcer remains an important medical observation and is a testament to Cushing's broad accomplishments.
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Despite recent findings of cognitive, emotional, physical, and behavioral symptomatology in retired professional athletes with a history of multiple concussions, there is little systematic research examining these symptoms in high school athletes with a history of concussion. ⋯ It appears that youth athletes who sustain multiple concussions experience a variety of subtle effects, which may be possible precursors of the future onset of concussion-related difficulties.