No shinkei geka. Neurological surgery
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Case Reports
[Motor cortex stimulation for post-stroke pain using neuronavigation and evoked potentials: report of 3 cases].
Although motor cortex stimulation (MCS) has been accepted as an effective therapeutic option for central pain, the efficacy of MCS widely varies among previous reports. In this report, we describe our recent trial for successful MCS in 3 patients with central pain due to cerebral stroke. Medical treatments were transiently effective, but gradually became ineffective in all of the cases. ⋯ After surgery, pain almost resolved in 2 of 3 patients and markedly improved in another. The pain relief depended on their motor function. These findings strongly suggest that both patient selection and intraoperative monitoring for targeting the motor cortex are quite important for successful MCS, although further studies were essential.
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Hair removal or shaving, even if partial, increases mental anguish of patients, especially in female. Several reports demonstrating successful cranial surgery without hair removal led us to start cranial surgery with completely preserving hair. The purpose of this study was to demonstrate our methods and tips of cranial surgery without hair removal and to evaluate the rate of postoperative infection in these patients. ⋯ There was no significant difference between the rate of wound complication in patients whose heads were shaven (5/82) and the rate in those whose head were not shaven (7/82). So we suggest that neurosurgery without shaving is safe, and does not increase the risk of severe wound infection. In addition, it helps patients to look normal and to start their routine earlier.