Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Post-herpetic neuralgic affects up to 20% of patients after an attack of trigeminal Herpes Zoster infection. Past medical and surgical treatments have been unrewarding. We report the successful treatment of such a case with deep brain stimulation into the region of the contralateral periventricular grey area (PVG) and ventral posterior lateral thalamic nucleus (VPL).
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Case Reports
Tension pneumocephalus following transsphenoid surgery for pituitary adenoma - report of two cases.
Occurrence of symptomatic pneumocephalus following transsphenoid surgery is a rare event. Two cases of symptomatic pneumocephalus were observed in our series of 480 transsphenoidal surgeries. The first case reported presented with a head injury 4 years earlier and had a left frontotemporal haematoma evacuation. ⋯ He developed postoperative CSF rhinorrhea and in spite of conservative therapy, developed progressive visual deterioration necessitating a re-exploration and repair leading to resolution of the neurological deficits. The second case presented with delayed CSF rhinorrhea leading to rapid alteration in sensorium, requiring external ventricular drainage. The leak subsided without any further surgical intervention.
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Case Reports
Isolated unilateral hypoglossal nerve paralysis caused by an atlanto-occipital joint synovial cyst.
An isolated unilateral hypoglossal nerve lesion is an uncommon cranial nerve palsy. We report a case of isolated hypoglossal nerve paralysis caused by an intra-dural synovial cyst. To our knowledge, this is the first reported case of a twelfth nerve paralysis caused by a synovial cyst. The anatomy of the hypoglossal nerve, its blood supply and the relationship of the nerve to the atlanto-occipital joint are reviewed, along with the common causes of isolated hypoglossal nerve paralysis.
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The implanted peripheral nerve stimulator has a role for pain relief in well-selected patients with pain in a peripheral nerve distribution. We describe an electrode to help simplify the surgical implantation of a peripheral nerve stimulator and also to reduce the possibility of electrode migration following implantation. Design details of the electrode are discussed, as are notes on surgical technique.