World Neurosurg
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Neurogenic stunned myocardium (NSM) is a devastating complication of subarachnoid hemorrhage (SAH). The most widely accepted mechanism in the pathogenesis of NSM and takotsubo cardiomyopathy is catecholamine-mediated direct myocardial injury. The aim of this study is to examine if there is any effect of sympathetic overactivity of the stellate ganglions on myocardial tissues, secondary to vagal complex degeneration in SAH-induced NSM. ⋯ NSM and takotsubo cardiomyopathy may be induced by vagal complex degeneration and sympathetic overactivity, which originated from more neurons, including stellate ganglia and more degenerated neuron densities of nodose ganglia.
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Severe kyphosis is infrequently seen in neonates with myelomeningoceles. Spinal skeletal dysmorphology complicates repair, as local tissue may be insufficient to cover the dural repair. Although neonatal kyphectomy has been proposed as a potential solution to this problem, it carries significant potential risks that may not be acceptable to families. ⋯ Acellular dermal matrix is a potentially useful adjunct for definitive reconstruction of complex neonatal soft tissue defects where local tissue is not available.
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The underlying mechanisms of headache in adult moyamoya disease (MMD) are not clear. The aim of this study is to clarify the factors that are associated with headache in adult patients with MMD after superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis. ⋯ The results of our analyses revealed that aside from ischemia, the postoperative increase rate of the STA may be a candidate reason for headache, especially in adult patients with MMD.
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Acute anterior inferior cerebellar artery (AICA) occlusion is considered an acute ischemic stroke requiring medical treatment without mechanical thrombectomy (MT). There is a procedural risk of parent vessel rupture, but neurologic deficits are not generally severe. Here, we report a case of MT performed using partially deployed stent retrieval for acute AICA occlusion. ⋯ Our case suggests that MT can be performed in a highly selective manner in patients with the occlusion of a posterior circulation branch, such as the AICA, and yield a good clinical outcome.
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Granulocyte-colony stimulating factor (G-CSF) has been observed to have direct protective effects on neurons after stroke in experimental models and in humans. In the present study, the antiapoptotic effects of G-CSF on spinal α-motoneurons after inducement of peripheral sciatic nerve lesions were evaluated in a rat model. ⋯ The results indicated that G-CSF has neuroprotective properties in spinal α-motoneurons and contributes to antiapoptotic effects after peripheral nerve lesions. The relevance of G-CSF, its precise mode of action, and the effect of these findings in clinical situations remains to be elucidated and require examination in further studies.