World Neurosurg
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This study evaluates the efficacy of linear accelerator (LINAC) radiosurgery using micro multi-leaf collimator technique (μMLC) in the treatment of a consecutive series of patients with vestibular schwannomas. ⋯ LINAC radiosurgery using a micro multi-leaf collimator for vestibular schwannomas smaller than 3 cm is effective in yielding a high local tumor control, whereas the treatment-related morbidity remains low.
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Review
Prevalence and incidence of drug-resistant mesial temporal lobe epilepsy in the United States.
We reviewed data on the epidemiology of epilepsy in the United States and estimated the prevalence and incidence of drug-resistant temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS) based on extrapolation from the available data drawn from the literature. ⋯ Although full scale epidemiologic studies on drug-resistant HS-TLE are needed, several observational studies allow adequate estimates of the range for the incidence and prevalence of this condition. Given the morbidity and mortality associated with poorly controlled seizures, this relatively large and growing patient population is a matter of concern. Considering the variety of treatment options that are available or in the pipeline to treat drug-resistant epilepsy, future efforts should focus on advocating for early referral of patients with drug-resistant HS-TLE for more comprehensive epilepsy management.
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The dense and complex distribution of neural structures in the brainstem makes it challenging to understand their real configuration. We used the fiber microdissection technique to show the course of the medial and lateral lemnisci within the brainstem. Although these structures seem anatomically alike, they are functionally distinct. ⋯ Using the fiber microdissection technique, we were able to define a general perspective of the topography and architecture of the medial and lateral lemnisci in the brainstem. This perspective should be incorporated into interpretations of magnetic resonance imaging techniques, recognizing both their benefits and limitations. It should also be applied to surgical planning and strategies to achieve a safer and more precise microsurgical procedure.
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In Japan, neurosurgeons have traditionally mainly treated brain diseases, with most cases involving the spine and spinal diseases historically being treated by orthopedists. Nowadays, spinal surgery is 1 of the many subspecialties in the neurosurgical field in Japan. ⋯ Neurosurgeons in Japan must rethink the educational program to include advanced trauma life support and spinal surgery.
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Multicenter Study
Cervical Spinal Cord Injury without Computed Tomography evidence of trauma (SCIWOCTET) in adults: MRI prognostic factors.
Spinal cord injury (SCI) without computed tomography evidence of trauma is underreported in adults and is considered a subtype of SCI with relatively good outcome. Despite this, few studies have been performed to determine specific imaging-related prognostic factors. Our objective is to describe the imaging characteristics of patients experiencing blunt cervical spine trauma with neurologic deficits, but without radiologic abnormalities and associated prognostic factors. ⋯ Early MRI has prognostic value in patients suffering SCI without computed tomography evidence of trauma. Lesion length is a powerful predictor of outcome in this subgroup of patients. Soft tissue injury plays a role in the severity of injury and the ability to recover in this subgroups of patients.