World Neurosurg
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Tourette syndrome is a chronic neuropsychiatric disorder characterized by motor and vocal tics. In the majority of cases, tics are associated by behavioral disorders such as obsessive-compulsive behavior. First symptoms typically appear in early childhood. ⋯ In the majority of the published cases, there is a clear effect on tics but most studies consist of only a limited number of patients. A strict patient selection is absolutely mandatory. There is a need for double-blinded multicenter trials with inclusion of more patients.
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The purpose of this study was to report our neurosurgical experience with traumatic brain injury (TBI) at a departmental teaching hospital in Benin. ⋯ Surgical treatment of TBI is a common activity in our practice, despite the difficulties. Good imaging and enhanced prevention could improve care and reduce TBI severity.
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Surgery in psychiatric disorders has a long history and has regained momentum in the past few decades with deep brain stimulation (DBS). DBS is an adjustable and reversible neurosurgical intervention using implanted electrodes to deliver controlled electrical pulses to targeted areas of the brain. It holds great promise for therapy-refractory obsessive-compulsive disorder. ⋯ Another promising indication is Tourette syndrome, where potential efficacy of DBS is shown by several case series and a few controlled trials. Further research should focus on optimizing DBS with respect to target location and increasing the number of controlled double-blinded trials. In addition, new indications for DBS and new target options should be explored in preclinical research.
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With increasing popularity of percutaneous spinal access for minimally invasive spinal neurosurgery, the treatment paradigm has shifted from open approaches to vertebroplasty or kyphoplasty for degenerative spinal disease and vertebral compression fractures. Addressing the challenges of this shift, we integrate the fluoroscopic studies of these percutaneous approaches with the three-dimensional surgical anatomy. Step-by-step techniques are illustrated in video demonstrations that highlight the nuances of effective percutaneous access during spinal surgeries for vertebral compression fractures and pedicle screw fixation. ⋯ With an appreciation for the standard anatomical landmarks, fluoroscopic views, and avenues of approach, percutaneous access techniques can be safely and effectively applied to many spinal procedures.
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Meta Analysis
Computed tomography for clearance of cervical spine injury in the unevaluable patient.
To review computed tomography (CT) as a stand-alone test for the clearance of cervical spine injury in the unevaluable patient population. ⋯ The evidence supporting CT for the stand-alone evaluation of the cervical spine in the unevaluable patient is insufficient. We contend that a CT of the cervical spine must be supplemented by an additional examination addressing ligamentous instability in this patient population.