Neurol Neurochir Pol
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Neurol Neurochir Pol · Jan 2014
Randomized Controlled TrialPerioperative outcome and cost-effectiveness of spinal versus general anesthesia for lumbar spine surgery.
General anesthesia (GA) is the most commonly used anesthetic technique for spinal surgery. This study aimed to compare spinal anesthesia (SA) and GA in patients undergoing spinal surgery, in terms of perioperative outcome and cost effectiveness. ⋯ SA could be considered a reliable alternative to GA in patients undergoing lumber spine surgery, as it is clinically as effective as GA, but more cost effective.
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Neurol Neurochir Pol · Jan 2014
ReviewPhantom phenomena and body scheme after limb amputation: a literature review.
Phantom phenomena are subject of various, often inconsistent, descriptions, and new concepts and treatment approaches emerge. The aim of the study is to describe contemporary terminology and developments in the field, and to share personal experience. ⋯ The terminology and classification of phantom phenomena sensations, relations between intensity and character of phantom pain to the etiology and level of amputations, as well as the influence of presence and intensity of pre-operative limb pain and post-operative stump pain on phantom phenomena are described. The benefits of mirror therapy and early introduction of prosthesis and applying functional prosthesis are also presented, with a glance at other conservative and surgical treatment approaches.
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Neurol Neurochir Pol · Jan 2014
Comparative StudyThe N-terminal pro-brain natriuretic peptide as a marker of mitoxantrone-induced cardiotoxicity in multiple sclerosis patients.
Mitoxantrone (MTX) has been shown to reduce progression of disability and number of clinical exacerbations in patients with progressive multiple sclerosis (MS). Prolonged administration of MTX, however, is limited by the risk of cardiotoxicity. Cardiac monitoring in MTX-treated patients includes usually measurement of left ventricular ejection fraction (LVEF) by means of echocardiography. The N-terminal pro-brain natriuretic peptide (NT-proBNP) represents a novel diagnostic tool in the assessment of heart failure. This study was aimed to evaluate the usefulness of NT-proBNP for early detection of MTX-induced cardiotoxicity in MS patients. ⋯ The results of our study confirm that MTX therapy is safe for carefully selected and closely monitored MS patients. We believe that serial evaluation of NT-proBNP levels (before, during and after MTX therapy) can identify MS patients at high risk for MTX-induced cardiotoxicity.
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We present our experience with surgery of jugular foramen schwannomas with special consideration of clinical presentation, surgical technique, complications, and outcomes. ⋯ Jugular foramen schwannomas can be radically managed with the use of skull base surgery techniques. However, the surgical treatment of jugular foramen schwannomas carries a significant risk of the lower CN deficits.
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Neurol Neurochir Pol · Jan 2014
Case ReportsDeep brain stimulation in the treatment of Holmes tremor - a long-term case observation.
We present the patient with Holmes tremor secondary to the infarction of thalamus, successfully treated with the deep brain stimulation (DBS) of the area between ventralis oralis anterior and zona incerta for a long time, in whom the severe tremor reappeared after removal of the DBS lead. This is the first presentation of the effective DBS on this location. Our case does not support the hypothesis that the DBS treatment could lead to sustained relief of symptoms after cessation of stimulation.