World Neurosurg
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Autism spectrum disorder represents a set of developmental disorders characterized by lack of social interaction and verbal and nonverbal communication in the first 3 years of life. It is also associated with several comorbidities, including epilepsy, aggression, self-mutilating behavior, and obsessive-compulsive behavior. In some cases, obsessive-compulsive disorder (OCD) develops. The nucleus accumbens (NAc) plays a key role in reward circuitry and is involved in the control of OCD and aggression. ⋯ This case report illustrated the role of the NAc in OCD and aggression in an autistic patient. We discussed the role of the NAc as a target to explain the outcome of this case.
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Superior cluneal nerve entrapment neuropathy is one cause of low back pain often referred to as "pseudo sciatica." Studies have found that the superior cluneal nerve can arise variably from T11 to L5. The osteofibrous tunnels formed by a groove on the iliac crest might compress the superior cluneal nerve. Therefore, the purpose of this study was to investigate the origin of the superior cluneal nerve and its course through such bony grooves. ⋯ These results could help identify such bony grooves and better understand low back pain and its related anatomy.
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The purpose of this study was to investigate neck movement and various conditions of the aortic arch that may hinder access to the carotid artery during neurointerventional procedures. ⋯ Factors such as older age, acute arch angle, higher elongation type, arch calcification, and carotid artery angulation were verified as factors affecting access by a simple catheter; however, neck extension was shown to facilitate access in about 10%-30% of patents.
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To observe anatomic relationships between lumbar bicortical pedicle screws (BPSs) at 2 sagittal section angles (SSAs) and lumbar artery (LA). ⋯ Lumbar BPSs present a risk of injury to the LA. The vertical angle is the recommended SSA for BPSs in L1 and L2, and the cephalic angle is the recommended SSA in L3 and L4.
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Neuromodulation is an evolving therapy for chronic pain. Aiming to meet the limitations of traditional spinal cord stimulation, dorsal root ganglion (DRG) stimulation targets pain in a dermatomal distribution at the site of pain transmission. Despite these advantages, lead migration is a significant complication that hinders the long-term efficacy of DRG stimulation. This study aims to identify risk factors for lead migration requiring revision in DRG stimulation. ⋯ Premature activity, hardware manipulation, and female sex appear to be associated with an increased risk for lead migration. Leads on the S1 and L4 locations may be more likely to migrate. Large trials are necessary to gain a more conclusive understanding of these risk factors for lead migration.