Neurological research
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Neurological research · Sep 1998
Influence of isoflurane anesthesia on motor evoked potentials elicited by transcortical, brainstem, and spinal root stimulation.
Electrical stimulation over the motor cortex, base of the skull, and cervical spine motor roots was performed in 9 male rats (410 +/- 86 g) before and after induction with isoflurane at 1 MAC concentration. The mean latency and amplitude of descending spinal evoked potential (DSEP) from spinal cord and motor evoked potentials (MEPs) from forearm muscles obtained after motor cortex, brainstem, and cervical root stimulations were calculated and compared. The electrical current intensity to elicit the MEPs after cortical, brainstem, and spinal roots stimulation were 23.4 +/- 7.6, 7.0 +/- 3.1, and 1.4 +/- 0.8 mA, respectively. ⋯ The amplitudes were 189 +/- 141, 672 +/- 354, and 765 +/- 389 microV for cortical, brainstem, and cervical root stimulations. The inhalation anesthesia isoflurane at 1 MAC (1.2%) completely abolished the cortical and brainstem MEPs within minutes, while the MEPs elicited by direct stimulation of the cervical spinal roots remained unchanged. Our results indicate synaptic-dependent MEPs elicited at motor cortex or brainstem levels are highly sensitive to isoflurane anesthesia.
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Neurological research · Jul 1998
Clinical Trial Controlled Clinical TrialSpinal cord stimulation revisited.
The proportion of patients with intractable pain successfully managed with spinal cord stimulation (SCS) remains disputed. We analyze 27 consecutive patients with intractable pain treated with SCS using identical hardware (Itrel II System; Medtronic Neurological, Inc Minneapolis, MN, USA) by a single satisfactory diagnosis 1992 through 1995. A rigid selection protocol was used: 1. ⋯ We conclude that rigid selection protocol can maximize the proportion of patients with intractable pain who are successfully treated with SCS. Strict neurosurgical technique eliminates infection risk. Hardware selection minimizes incidence of malfunction.
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Neurological research · Jun 1998
Review Case ReportsCutaneous T-cell lymphoma with intracerebral and bilateral intraocular spread.
Brain metastasis from systemic or cutaneous lymphoma is infrequently encountered. We present a case report of cutaneous T-cell lymphoma (CTCL) that metastasized to the brain. ⋯ This report focuses attention on the typical presentation and markedly poor prognosis that characterize this rare problem. It also emphasizes the suspicion with which a brain mass in a lymphoma patient with neurological changes should be regarded.
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Neurological research · Apr 1998
Case ReportsPial arteriovenous malformation with massive perinidal edema.
It is generally considered that perinidal edema in an arteriovenous malformation (AVM) is caused by a concomitant intracerebral hematoma. We report a rare case of AVM with perinidal massive edema which was possibly not due to hemorrhage, and discuss the pathophysiological mechanisms of such edema development. A 60-year-old woman presented with a sudden onset severe headache. ⋯ MR images 3 months after the operation showed marked reduction of perinidal edema. The time course of the perinidal edema suggests that its development was unrelated to the hemorrhage. The findings indicate that increased venous pressure secondary to severe stenosis of the draining vein may possibly contribute to the development of perinidal edema.
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Neurological research · Apr 1998
Correlation between intracranial pressure (ICP) and changes in CT images of cerebral hemorrhage.
The relationship between intracranial pressure and CT images was investigated in 80 cases of cerebral hemorrhage that occurred between 1984 and 1990. In traumatic intracerebral hematoma, positive correlation was found between intracranial pressure and both shift of midline structures and volume of hematoma except in the occipital lobe or at the base of the frontal lobe. ⋯ In nontraumatic subarachnoid hemorrhage, positive correlation existed between increased intracranial pressure and intraventricular hemorrhage as well as Evans' ratio calculated using repeat CT images that were obtained due to disturbances in cerebrospinal fluid circulation. These results suggest that the degree by which intracranial pressure increases in patients with cerebral hemorrhage can be estimated by the changes in CT images.