Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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We report our institutional experience using an electromagnetic navigation system, without rigid head fixation, for awake craniotomy patients. The StealthStation® S7 AxiEM™ navigation system (Medtronic, Inc.) was used for this technique. Detailed preoperative clinical and neuropsychological evaluations, patient education and contrast-enhanced MRI (thickness 1.5mm) were performed for each patient. ⋯ This offers the same accuracy as optical navigation, but without head pin fixation or interference with intraoperative neurophysiological techniques and surgical instruments. The application of the electromagnetic neuronavigation technology without rigid head fixation during an awake craniotomy is accurate, and offers superior patient comfort. It is recommended as an effective adjunctive technique for the conduct of awake surgery.
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In this systematic review, we aimed to profile the various reported interventions for camptocormia in Parkinson's disease (PD) and give an overview of the benefits of deep brain stimulation (DBS). Currently, there is no consensus in the literature regarding this. PD manifests in several ways and camptocormia is one of the commonly encountered problems for both spine and functional neurosurgeons. ⋯ However, major complications following spinal surgery were noted. Although the results are from a small group of patients, DBS has achieved sustained improvement in camptocormia with low postoperative morbidity, and appears to be a promising treatment option. A larger, long term study is necessary to establish comprehensive outcome data.
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We assess whether serum lactate is a potential biomarker for non-glial cell brain tumors. Rapidly growing tumor cells typically have glycolytic rates up to 200 times higher than those of their normal tissues of origin and produce lactate even in the presence of oxygen. This phenomenon is called the Warburg effect. ⋯ There was a statistically significant association between metastatic brain tumors and elevated serum lactate. We demonstrate that lactate can be used as a non-invasive biomarker to determine malignancy for brain tumors. Further analyses of larger populations will be needed to establish the value of serum lactate in determining the response to therapy or early recurrence.
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We have previously reported an increase of 0.6% in the relative risk of aneurysmal subarachnoid hemorrhage (aSAH) in response to every 1°F decrease in the maximum daily temperature (Tmax) in colder seasons from patients presenting to our regional tertiary care center. We hypothesized that this relationship would also be observed in the warmer summer months with ambient temperatures greater than 70°F. From prospectively collected incidence data for aSAH patients, we investigated absolute Tmax, average daily temperatures, intraday temperature ranges, and the variation of daily Tmax relative to 70°F to assess associations with aSAH incidence for patients admitted to our institution between 1991 and 2009 during the hottest months and days on which Tmax>70°F. ⋯ The proportion of days with aSAH admissions was lower on hotter days than the proportion of days with no aSAH (96% versus 98%; p=0.006). aSAH were more likely to occur during the summer and on days with a temperature fluctuation less than 10°F (8% versus 4%; p=0.002). During the hottest months of the year in the mid-Atlantic region, colder maximum daily temperatures, a smaller heat burden above 70°F, and smaller intraday temperature fluctuations are associated with increased aSAH admissions in a similar manner to colder months. These findings support the hypothesis that aSAH incidence is more likely with drops in temperature, even in the warmer months.
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We hypothesized that treatment with escitalopram would improve cognitive bias and contribute to the recovery process for patients with major depressive disorder (MDD). Many previous studies have established that patients with MDD tend to pay selective attention to negative stimuli. The assessment of the level of cognitive bias is regarded as a crucial dimension of treatment outcomes for MDD. ⋯ After the 8 week escitalopram treatment, no significant bias toward negative faces was observed in the patient group. In conclusion, patients with MDD pay more attention to negative facial expressions, and treatment with escitalopram improves this attentional bias toward negative facial expressions. This is the first study, to our knowledge, on the effects of treatment with escitalopram on attentional bias in patients with MDD that has employed a dot probe task of facial expression.