Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jan 2021
Supratentorial intracerebral hemorrhage volume and other CT variables predict the neurological pupil index.
There is growing interest in the ability of automated infrared pupillometry to assess severity of neurological illness. We studied the correlation between computed tomography (CT) indicators of intracerebral hemorrhage (ICH) severity with objective measures of the pupillary light reflex (PLR), and hypothesized that hemorrhage volume would predict the Neurological Pupil index™ (NPi™), an indicator of pupillary reactivity. ⋯ ICH volume and shift of midline structures correlate with NPi, and abnormalities in NPi can be predicted by hematoma volume and other CT indicators of ICH severity. Future studies should explore the role of NPi in detecting early hematoma expansion and worsening midline shift.
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Clin Neurol Neurosurg · Oct 2020
Multicenter StudyThe safety and efficacy of the LVIS stent for the treatment of ruptured intracranial aneurysms within 24 hours: A multicenter retrospective study.
Stent-assisted coiling is increasingly used in the treatment of acutely ruptured intracranial aneurysms. However, the optimal timing of the stent-assisted coiling remains unknown. We aimed to investigate the safety and efficacy of the Low Profile Visualized Intraluminal Support (LVIS) stent for ruptured aneurysms treatment within 24 h comparing to the treatment between 25 and 72 h of symptom onset. ⋯ The LVIS stent-assisted coiling may be safe and effective in the treatment of selected patients with ruptured aneurysms within 24 h of symptom onset.
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Clin Neurol Neurosurg · Jul 2020
Case ReportsNeurological manifestations of COVID-19 and other coronavirus infections: A systematic review.
Increasing research reports neurological manifestations of COVID-19 patients. SARS-CoV-2 shares homology with other human coronaviruses that have also had nervous system involvement. ⋯ An increasing number of reports of COVID-19 patients with neurological disorders add to emergent experimental models with neuro-invasion as a reasonable concern that SARS-CoV-2 is a new neuropathogen. How it may cause acute and chronic neurologic disorders needs to be clarified in future research.
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Clin Neurol Neurosurg · Oct 2020
ReviewTranssphenoidal surgery using robotics to approach the sella turcica: Integrative use of artificial intelligence, realistic motion tracking and telesurgery.
While full integration of robotic surgery has been achieved in other surgical domains, its transition into neurosurgery has been more prolonged, especially with respect to pituitary surgery. The confined working space and precise maneuvers required in endoscopic endonasal surgery makes development of an efficacious and safe robotic system difficult. Nevertheless, preclinical studies have attempted to demonstrate the feasibility of the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) in both transnasal and transoral approaches. ⋯ The possible role of concentric tube robotics surgery in skull base pathologies has been explored, and the novel use of telesurgery incorporated into robotic neurosurgery is discussed. An endoscopic endonasal transsphenoidal surgical system has also been developed, integrating computational methods to create a presurgical reconstructive model for surgical planning and automating the line of dissection for an enhanced approach to the sphenoid sinus. While surgical robotics for transsphenoidal surgery remain in its nascency, these preliminary findings are promising and suggest a role for robotic pituitary surgery.
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Clin Neurol Neurosurg · Jul 2020
Peripheral trigeminal branch stimulation for refractory facial pain: A single-center experience.
Facial pain refractory to medical treatments may benefit from neurosurgical interventions. Only a few studies have reported on the efficacy of peripheral trigeminal stimulation and more specifically supraorbital nerve (SON) and infraorbital nerve (ION) stimulation for the treatment of facial pain. ⋯ SON and/or ION stimulation can be an effective treatment for intractable facial pain due to post-herpetic, traumatic or idiopathic etiology; however the complication rate is relatively high. Future prospective studies with longer follow-up periods are warranted.