World Neurosurg
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Spondyloepiphyseal dysplasia (SED) is a rare disease that causes vertebral abnormalities and short-trunk dwarfism. The two forms of SED are congenita and tarda. Each form arises in a genetically distinct fashion and manifests with a different set of complications. SED congenita is more severe, and patients usually display atlantoaxial instability and odontoid hypoplasia. Patients often have various neurologic deficits caused by compression of the spinal cord. The region most affected is the craniovertebral junction (CVJ). ⋯ In this article, the authors survey the current literature surrounding neurosurgical interventions and present an algorithm for treatment.
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Review Meta Analysis
Radiosurgery for the treatment of psychiatric disorders: a review.
Radiosurgery for psychiatric disorders has been performed for more than 50 years. The use of deep brain stimulation has recently been expanded to the investigational treatment of specific psychiatric disorders. ⋯ The anatomic target localization, dose selection, and the outcome of the radiosurgical procedures were reviewed, and the evolutions of lesioning strategies were analyzed with particular emphasis on the dose selection. Large-scale prospective studies with strict inclusion and well-defined, objective outcome criteria are necessary for defining the role of radiosurgery for the treatment of psychiatric disorders.
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Review Case Reports
Deep brain stimulation for obsessive-compulsive disorder: subthalamic nucleus target.
Because of its reversibility and adaptability, deep brain stimulation (DBS) has recently gained interest in psychiatric disorders, such as obsessive-compulsive disorders (OCD) and depression. In OCD, DBS is now an alternative procedure to lesions of fascicles such as the anterior capsule, which links the orbitofrontal cortex, the cingulum, and the thalamus, and has been applied to new target such as the nucleus accumbens, with promising results. However, a recent interest has been developed toward the subthalamic nucleus (STN), a key structure of the basal ganglia that connects the motor, limbic, and associative systems. ⋯ Those transient effects are usually seen as "side effects" in Parkinson disease, but are clues to the underappreciated role that STN plays in the limbic circuitry, a role whose precise details are as yet unknown and under active investigation. We present the rationale supporting the use of nonmotor STN as a therapeutic target to treat OCD. In particular, we discuss the recent experience and preliminary results of our group after 6 months of nonmotor STN-DBS in patients with severe OCD.