Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jul 2012
ReviewIntrathecal granuloma formation as result of opioid delivery: systematic literature review of case reports and analysis against a control group.
To investigate the existence of an association between formation of catheter tip intrathecal inflammatory masses with opioid dose and/or concentration. ⋯ Opioid dose and concentration were significantly associated with the development of catheter tip granulomas. A correlation with opioid concentration was confirmed for the first time.
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Clin Neurol Neurosurg · Jul 2012
Visual outcome after fronto-temporo-orbito-zygomatic approach combined with early extradural and intradural optic nerve decompression in tuberculum and diaphragma sellae meningiomas.
The surgical challenge of the treatment of tuberculum (TSMs) and diaphragma sellae meningiomas (DSMs) is to preserve or improve the visual function. Extradural and intradural optic nerve decompression should reduce surgical trauma of the nerve achieving a good visual result. ⋯ Using this surgical technique we achieved a high improvement rate of visual defects and a low frequency of worsening.
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Clin Neurol Neurosurg · Jun 2012
Case ReportsDiaphragm paralysis caused by transverse cervical artery compression of the phrenic nerve: the Red Cross syndrome.
The etiology of diaphragm paralysis is often elusive unless an iatrogenic or traumatic injury to the phrenic nerve can be clearly implicated. Until recently, there has been little interest in the pathophysiology of diaphragm paralysis since few treatment options existed. ⋯ We suggest that vascular compression of the phrenic nerve in the neck may occur following traumatic or iatrogenic injuries, and result in symptomatic diaphragm paralysis.
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Clin Neurol Neurosurg · Jun 2012
ReviewNeuromodulation of lower limb motor control in restorative neurology.
One consequence of central nervous system injury or disease is the impairment of neural control of movement, resulting in spasticity and paralysis. To enhance recovery, restorative neurology procedures modify altered, yet preserved nervous system function. This review focuses on functional electrical stimulation (FES) and spinal cord stimulation (SCS) that utilize remaining capabilities of the distal apparatus of spinal cord, peripheral nerves and muscles in upper motor neuron dysfunctions. ⋯ This will lead to our human work of epidural and transcutaneous stimulation targeting the lumbar spinal cord for enhancing motor functions in spinal cord injured people, supplemented by pertinent human research of other investigators. We conclude that the concept of restorative neurology recently received new appreciation by accumulated evidence for locomotor circuits residing in the human spinal cord. Technological and clinical advancements need to follow for a major impact on the functional recovery in individuals with severe damage to their motor system.