World Neurosurg
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Biography Historical Article
The philosopher's swoon--the concussion of Michel de Montaigne: a historical vignette.
The French philosopher Michel Eyquem de Montaigne (1533-1592) sustained a transient loss of consciousness due to a head injury. Montaigne described his concussion as a "swoon," with astutely illustrative details of the symptoms he experienced, including brief loss of consciousness, with apparent (temporary) confusion, and post-traumatic amnesia. His vivid portrayal of the recovery period lends understanding of the process of conscious awakening after his near-death experience. Thanks to his power of introspection and literary talent we may gain insight into the feelings and perceptions of some patients during their recovery from concussion.
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Comparative Study
Intraarterial colforsin may improve the outcome of patients with aneurysmal subarachnoid hemorrhage: a retrospective study.
Papaverine hydrochloride (PPV) has been widely used for pharmacologic angioplasty to dilate spastic vessels after aneurysmal subarachnoid hemorrhage (SAH). Colforsin daropate hydrochloride (CDH) has also recently been reported to be useful for reversal of cerebral vasospasm (CV). In this study, we compared the impacts of intraarterial PPV and CDH on the outcomes of SAH patients. ⋯ CDH appears to be associated with a better outcome in patients with SAH.
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Arthrodesis is considered to be the reference treatment for degenerative disc disease (DDD), if the symptoms are refractory to conservative management. The drawback of arthrodesis is, besides a percentage of non-union, the reduced mobility that might generate an increased load and risk for degeneration of the adjacent levels. Total disc replacement (TDR) implants may overcome this problem. The long-term clinical effect and radiographic evaluation of motion preservation after implantation, however, have been subject to several nonconclusive studies. This study evaluated the long-term clinical and radiographic results and the safety of TDR with the Maverick prosthesis for surgical treatment of monosegmental DDD. ⋯ In this study, TDR with the Maverick prosthesis at one lumbar segment reduced pain and disability and improved quality of life as well as the general condition. Motion was preserved at the operated level, 48 months after surgery. The long-term effect on adjacent levels needs further follow-up.
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Comparative Study Historical Article
From planes to brains: parallels between military development of virtual reality environments and virtual neurological surgery.
Military explorations of the practical role of simulators have served as a driving force for much of the virtual reality technology that we have today. The evolution of 3-dimensional and virtual environments from the early flight simulators used during World War II to the sophisticated training simulators in the modern military followed a path that virtual surgical and neurosurgical devices have already begun to parallel. By understanding the evolution of military simulators as well as comparing and contrasting that evolution with current and future surgical simulators, it may be possible to expedite the development of appropriate devices and establish their validity as effective training tools. As such, this article presents a historical perspective examining the progression of neurosurgical simulators, the establishment of effective and appropriate curricula for using them, and the contributions that the military has made during the ongoing maturation of this exciting treatment and training modality.
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Comparative Study
Inclusion of asymptomatic degenerative discs in a two-level anterior cervical discectomy and fusion: a decision analysis.
To perform a decision analysis model to compare single-level fusion versus two-level fusion in patients with an asymptomatic disc adjacent to a symptomatic disc. ⋯ Observation was the preferred strategy for management of asymptomatic adjacent degenerative discs (AADDs) given the probabilities and utilities used in the decision analysis model. The study was limited by unavailability of precise estimates of the probability of development of ASD and the probability of surgery after diagnosis of ASD, the most critical factors influencing the decision. However, the conclusions were robust given wide ranges used for these parameters in the sensitivity analysis.