Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Dec 2011
ReviewMicrovascular decompression surgery for trigeminal neuralgia and hemifacial spasm: naunces of the technique based on experiences with 100 patients and review of the literature.
Microvascular decompression (MVD) surgery for trigeminal neuralgia and hemifacial spasm offers a relatively low-risk opportunity to treat cranial nerve hyperactivity-compression syndromes, which are associated with severe, disabling facial pain and spasm. Although a number of publications have described the technique in detail, combining the technical nuances from different schools of thought or neurosurgical training in an effort to increase the safety and efficacy of this procedure would be beneficial to the surgeon. ⋯ In the presence of alternative methods of therapy, microvascular decompression operations should be performed with low risk to the patient. There is a learning curve involved with this operation and the surgeon should remain always critical of his/her performance and aspire for a "perfect" result.
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Clin Neurol Neurosurg · Dec 2011
Review Meta AnalysisDiagnostic performance of iodine-123-metaiodobenzylguanidine scintigraphy in differential diagnosis between Parkinson's disease and multiple-system atrophy: a systematic review and a meta-analysis.
This study was designed to review the diagnostic performance of iodine-123-metaiodobenzylguanidine (MIBG) scintigraphy in differential diagnosis between Parkinson's disease (PD) and multiple-system atrophy (MSA). ⋯ MIBG scintigraphy is an accurate test for PD detection and differential diagnosis between PD and MSA; this method shows high sensitivity and adequate specificity in this field. Nevertheless, possible causes of false negative and false positive findings should be considered when interpreting the scintigraphic results.
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The primary treatment of meningiomas is surgery which can be curative if the tumor is completely removed. For parasagittal, lateral sphenoid wing and olfactory groove meningiomas, gross-total resection should be the goal. Tuberculum and diaphragma sella meningiomas can be resected through the subfrontal or the pterional approaches. ⋯ Stereotactic radiosurgery can be used as an alternative treatment to surgery either as a first-line treatment or at recurrence. Various conventional radiotherapy techniques can be employed for residual tumor post surgery or at recurrence. Chemotherapy has modest activity and is reserved for selected cases.
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Clin Neurol Neurosurg · Jul 2009
ReviewThe complexity of neurobiological processes in acute ischemic stroke.
There is an urgent need for improved diagnostics and therapeutics for acute ischemic stroke. This is the focus of numerous research projects involving in vitro studies, animal models and clinical trials, all of which are based on current knowledge of disease mechanisms underlying acute focal cerebral ischemia. ⋯ In this review, we summarize the actual knowledge on the pathophysiology of acute ischemic stroke. We focus on the ischemic cascade, which is a complex series of neurochemical processes that are unleashed by transient or permanent focal cerebral ischemia and involves cellular bioenergetic failure, excitotoxicity, oxidative stress, blood-brain barrier dysfunction, microvascular injury, hemostatic activation, post-ischemic inflammation and finally cell death of neurons, glial and endothelial cells.
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Clin Neurol Neurosurg · Jul 2009
Review Case ReportsAdult medulloblastoma and the "dural-tail" sign: rare mimic of a posterior petrous meningioma.
The authors describe clinical and radiological features of a 32-year-old male patient with a posterior fossa lesion. The radiological characteristics resembled an extra-axial lesion; a meningioma, with attachment to the tentorium and petrous bone. ⋯ We review literature of this atypical presentation of medulloblastoma and "dural-tail" sign, which can be associated with other benign or malignant lesions. The role of magnetic resonance spectroscopy in the diagnosis of primitive neuroectodermal tumors is discussed.