World Neurosurg
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To evaluate the effects of reoperation with deep brain stimulation (DBS) in the caudal zona incerta (cZi) in patients with failed DBS in the ventral intermediate (Vim) nucleus of the thalamus for essential tremor. ⋯ The effect on tremor was, in this small sample population, improved by implanting an electrode in the cZi. The effect was modest in those patients suffering a deterioration years after the initial operation.
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To determine whether perfusion computed tomography (CT) is useful for identifying patients with poor-grade subarachnoid hemorrhage (SAH) with reversible etiologies and whether early obliteration in patients with poor-grade aneurysmal SAH leads to favorable outcomes. ⋯ Early bilateral prolonged MTT at the thalami and old age are associated with a poor outcome. Early obliteration benefits a significant portion of SAH patients.
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Case Reports
Anterior thigh compartment syndrome and local myonecrosis after posterior spine surgery on a Jackson table.
Acute compartment syndrome (ACS) after posterior spinal surgery is very uncommon. Most of the reported cases have ACS in the legs related to positioning in the knee-chest position; postoperative ACS in the thighs is exceedingly rare, with only one reported case (17). ⋯ Our cases indicate the need for a high index of suspicion of ACS in patients who have persistent unresolved pain and local swelling. Tissue pressure monitoring is an option in suspected cases. Iliac crest and thigh pads should not be reversed during positioning on a Jackson table.
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Although neurosurgical procedures are frequently performed in its territory, the zygomaticotemporal nerve (ZTN) is rarely mentioned in this literature, even though this nerve has been implicated in postsurgical pain syndromes and may become entrapped, resulting in chronic headache. The present study was performed to further elucidate the anatomy of the ZTN. ⋯ Based on our study, the ZTN has a fairly standard course that takes it along a superficial pathway overlying the pterion. It is our hope that with a greater appreciation for its anatomy and landmarks for its localization as provided herein, that injury to the ZTN may be avoided with surgical procedures in its territory, and if entrapped, may be more easily identified by the surgeon.
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Tumor-to-tumor metastasis is a rare but well-known phenomenon. Among the more than 100 intracranial tumors reported, meningiomas are the most common type, whereas schwannoma is extremely rare. ⋯ [(18)F]-fluorodeoxyglucose positron emission tomography is effective in the preoperative diagnosis of rapidly growing cerebellopontine angle tumors in patients with a history of malignancy.