Clinical neurology and neurosurgery
-
Clin Neurol Neurosurg · Oct 2020
Middle meningeal artery embolization for chronic subdural hematoma with high risk of recurrence: A single institution experience.
Middle meningeal artery (MMA) embolization can be a treatment option for selected cases of chronic subdural hematoma (CSDH) patients. However, appropriate timing of this procedure or the conditions to be considered are still not standardized. ⋯ MMA embolization is effective and safe in preventing recurrence of CSDH with high risk of recurrence, and could be a standard treatment for such cases.
-
Clin Neurol Neurosurg · Sep 2020
Randomized Controlled Trial Comparative StudyThe treatment of V2 + V3 idiopathic trigeminal neuralgia using peripheral nerve radiofrequency thermocoagulation via the foramen rotundum and foramen ovale compared with semilunar ganglion radiofrequency thermocoagulation.
To compare the advantages and disadvantages of V2 + V3 idiopathic trigeminal neuralgia using peripheral nerve radiofrequency (RF) thermocoagulation (PRF) via the foramen rotundum (FR) and foramen ovale (FO) with those of semilunar ganglion RF thermocoagulation (GRF) under local anesthesia, for exploring a new and available surgical method for patients with V2 + V3 idiopathic trigeminal neuralgia. ⋯ The PRF surgery, like GRF, is another prospective treatment for V2 + V3 idiopathic trigeminal neuralgia by virtue of its excellent immediate effect, accurate positioning and high safety.
-
Clin Neurol Neurosurg · Sep 2020
Minimum clinically important difference of major patient-reported outcome measures in patients undergoing decompression surgery for lumbar spinal stenosis.
A minimum clinically important difference (MCID) has been increasingly well known in the current era of patient-centered care because it reflects a smallest change that is meaningful for patients following a clinical intervention. Previous studies suggested MCID values are disease and/or procedure dependent. No MCID values have been reported on the lumbar spinal stenosis (LSS) following decompression surgery despite LSS is the most common spinal disease and the main treatment is decompression surgery. Therefore, this study aimed to determine the MCID values as major outcome measures including the Numeric Rating Scale (NRS) of back pain, leg pain and numbness, Roland-Morris Disability Questionnaire (RMDQ), and Physical Component Summary (PCS) and Mental Component Summary (MCS) of Short Form 8 (SF-8) for patients with LSS undergoing decompression surgery. ⋯ We first identified the MCIDs of the NRS, RMDQ, and SF-8 specific to patients undergoing decompression surgery for LSS.
-
Clin Neurol Neurosurg · Sep 2020
Risk factors of unplanned neurosurgery for scoliotic patients with Chiari malformation type I and syringomyelia after spinal deformity correction.
It remains unclear which subgroups of scoliotic patients with CMI and syringomyelia are more likely to undergo unplanned neurosurgery after spinal deformity correction. The purpose of this study is to explore risk factors of unplanned neurosurgery for scoliotic patients with CMI and syringomyelia after spinal deformity correction. ⋯ After spinal deformity correction, 78 % of the patients did not require later neurosurgery and those that needed it had a delay of more than nine months. Tonsil ectopia ≥ 10 mm and syrinx/cord area ratio ≥ 0.4 were independent risk factor of unplanned neurosurgery after spinal deformity correction. It is reasonable to perform spinal corrective surgery in patients with minimal symptoms and signs without the need for prior neurosurgical intervention.