Neuromodulation : journal of the International Neuromodulation Society
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We hypothesize that intrathecal (IT) granulomas arising from the IT infusion of several opiates may result from the degranulation of meningeal mast cells (MC). Given functional covariance between cutaneous and meningeal MC, we propose that opioids that do not degranulate cutaneous MC will not produce a granuloma. An opioid meeting this criteria is the phenylpiperadine alfentanil HCl. ⋯ These results support the hypothesis linking MC degranulation and IT granulomas.
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Eddy currents in the metal shell and copper losses in the coils generate heat in rechargeable neurostimulators, which increases the temperature of the adjacent tissue, potentially causing thermal damage of implant patients. Hence, there is an urgent need for a simple self-help method to measure the temperature of such subcutaneous devices. ⋯ A convenient method was then given to monitor the adjacent skin temperature to evaluate the thermal hazards with a skin temperature threshold of 41°C. The proposed approach can be easily implemented by an implant patient at home to reduce the thermal risk, ease patient anxiety, and improve clinical outcomes.
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Case Reports
Cerebral venous infarction: a potentially avoidable complication of deep brain stimulation surgery.
Despite numerous reports on the morbidity and mortality of deep brain stimulation (DBS), cerebral venous infarction has rarely been reported. We present four cases of venous infarct secondary to DBS surgery. ⋯ Cerebral venous infarction is a potentially avoidable, but serious complication. To minimize its incidence, we propose the use of high-resolution, contrast-enhanced, T1-weighted MR images to delineate cerebral venous anatomy, along with careful stereotactic planning of the lead trajectory to avoid injury to venous structures.