Der Nervenarzt
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The mammalian brain is capable of a substantial functional reorganization, manifesting on a cortical somatotopical and on a behavioral level. Possible mechanisms are reviewed based on the work by others and ourselves on somatosensory reorganization in humans. The somatosensory system is characterized by divergent projections from the periphery to the cerebral cortex. ⋯ Plastic changes can be temporary or persistent. Modulating factors like pain and certain drugs seem to induce a permissive state in the cortex resulting in enhanced reorganization. Thus, specific physical training combined with pharmacoceutical modulation holds promise to improve functional recovery after brain lesions.
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Review Case Reports
[Pseudoaneurysm of the extracranial internal carotid artery. Treatment by stent and coil implantation].
Pseudoaneurysms of the extracranial internal carotid artery (ICA) can be caused by external injury or may be due to spontaneous dissection. Pseudoaneurysms bear an increased risk of arterio-arterial embolism. Treatment of pseudoaneurysms is influenced by the location and the type of injury, associated injuries, collaterals to the ipsilateral hemisphere, neurological signs and symptoms, growth of the lesion and patient age. ⋯ Pseudoaneurysms of the ICA adjacent to the skull base require a major surgical procedure. If there are contra-indications for vessel occlusion conservative or medical treatment used to be the only therapeutic alternatives. We report the treatment of two patients with extracranial ICA pseudoaneurysms after blunt injury with stent placement (in one case combined with coil embolization) as a further treatment option.