Neurological research
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Neurological research · Dec 2005
Reducing unnecessary morbidity from percutaneous thermocoagulation in the treatment of trigeminal neuralgia--part C: a starting point for a somatotopic map of the human Gasserian ganglion.
An original method and technique has been designed to reduce the significant morbidity associated with techniques currently used for percutaneous thermocoagulation in the treatment of trigeminal neuralgia. The current report deals with the mathematical and biostatistical analysis of verbal responses gathered using such a method in an attempt, as a starting point, to establish the somatotopic organization of the human gasserian ganglion. ⋯ From the strict clinical point of view, the somatotopic map of each individual is invariant and easily analysed over long time periods. Its precise knowledge is critical for inducing smaller, properly placed lesions, in order to avoid unnecessary morbidity from percutaneous thermocoagulation in the treatment of trigeminal neuralgia. The proposed sequence of the gasserian somatotopic organization will be hopefully a useful guide for those interested in trigeminal physiological organization as well as for the therapeutic exploration of gasserian trigeminal fibers.
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Neurological research · Dec 2005
Carotid endarterectomy without shunt: the role of cerebral metabolic protection.
The optimal method to protect the brain from hemodynamic ischemia during carotid endarterectomy (CEA) remains controversial. This study reports our experience with induced arterial hypertension and selective etomidate cerebral protection in a cohort of patients who underwent CEA without shunting and continuous electroencephalography (EEG) monitoring. ⋯ Carotid endarterectomy can be safely performed with EEG monitoring and selective induced arterial hypertension and etomidate cerebral protection. Our results suggest that this method may be a good alternative for shunting and its inherent risks.