Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Sep 2013
Homocysteine, vitamin B12 and folate levels in Iranian patients with Multiple Sclerosis: a case control study.
Recently, homocysteine (Hcy), folate, and vitamin B12 have been proposed to have several roles on MS pathogenesis. ⋯ We concluded that serum levels of vitamin B12 and folate decreased in RRMS patients, but Hcy levels increased significantly. It seems necessary to conduct prospective trials to determine whether the treatment with supplements and correct biomarker levels in the early stage of the disease can change the course of the disease. We recommend regular checking of the serum level of Hcy in patients who use disease-modifying drugs.
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Clin Neurol Neurosurg · Sep 2013
Complications following cranioplasty using autologous bone or polymethylmethacrylate--retrospective experience from a single center.
A decompressive hemicraniectomy is a potentially life-saving intervention following head trauma. Once performed patients are obliged to undergo a second procedure with cranioplasty. Two of the most commonly used materials are autologous bone and polymethylmethacrylate (PMMA). We have now evaluated complications following a cranioplasty using these materials. ⋯ In our series we had a high percentage of patients needing re-operation due to complications following a cranioplasty. Though generally considered a straightforward procedure, complications and associated morbidity in patients undergoing cranioplasty should not be underestimated.
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Clin Neurol Neurosurg · Sep 2013
Carotid pseudo-occlusion on CTA in patients with acute ischemic stroke: a concerning observation.
Differentiation between an occluded and a patent extracranial internal carotid artery (ICA) is crucial in the diagnostic workup of patients with acute ischemic stroke; particularly in patients eligible for endovascular treatment. We report neurological and radiological findings of cases in which CTA in the acute phase incorrectly revealed an occlusion of the ICA. ⋯ CTA in the acute phase of ischemic stroke needs to be interpreted with severe caution, and in endovascular treatment decisions we should be aware that an extracranial ICA occlusion may be a false positive finding.
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Clin Neurol Neurosurg · Sep 2013
Reconstruction of pterional defects after frontotemporal and orbitozygomatic craniotomy using Medpor Titan implant: cosmetic results in 98 patients.
Reconstruction of pterional and temporal defects after frontotemporal (FT) and orbitozygomatic (OZ) craniotomy is important for avoidance of temporal hollowing, maintaining functional restoration, and achieving optimal cosmesis. The objective of this study is to describe our experience and cosmetic results with pterional reconstruction after FT and OZ craniotomy with the Medpor Titan implant. ⋯ Our technique using the Medpor Titan implant is a fast and effective method for pterional reconstruction after FT and OZ craniotomy with excellent cosmetic results and patient satisfaction. The implant combines the advantages of both porous polyethylene and titanium mesh, including easy custom-shaping without sharp edges, structural support and relatively lower cost.
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Clin Neurol Neurosurg · Sep 2013
Shortening the learning curve in endoscopic endonasal skull base surgery: a reproducible polymer tumor model for the trans-sphenoidal trans-tubercular approach to retro-infundibular tumors.
Endoscopic endonasal skull base surgery attracts an increasing number of young neurosurgeons. This recent technique requires specific technical skills for the approaches to non-pituitary tumors (expanded endoscopic endonasal surgery). Actual residents' busy schedules carry the risk of compromising their laboratory training by limiting significantly the dedicated time for dissections. ⋯ Training on easily reproducible retro-infundibular approaches in a context of pathological distorted anatomy provides a unique opportunity to avoid the need for repetitive live surgeries to acquire skills for this kind of rare tumors, and may shorten the learning curve for endoscopic endonasal surgery.