Journal of neurosurgery
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Journal of neurosurgery · Oct 2004
Case ReportsDeep brain stimulation of the ventral caudate nucleus in the treatment of obsessive-compulsive disorder and major depression. Case report.
Obsessive-compulsive disorder (OCD) is an anxiety disorder associated with recurrent intrusive thoughts and repetitive behaviors. Although conventional pharmacological and/or psychological treatments are well established and effective in treating OCD, symptoms remain unchanged in up to 30% of patients. Deep brain stimulation (DBS) of the anterior limb of the internal capsule has recently been proposed as a possible therapeutic alternative in treatment-resistant OCD. ⋯ Remission of OCD (Y-BOCS < 16) was also delayed after 12 or 15 months of DBS. The level of functioning pursuant to the GAF scale progressively increased during the 15-month follow-up period. No neuropsychological deterioration was observed, indicating that DBS of the ventral caudate nucleus could be a promising strategy in the treatment of refractory cases of both OCD and major depression.
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Journal of neurosurgery · Oct 2004
Alpha2-adrenergic receptor subtype specificity of intrathecally administered tizanidine used for analgesia for neuropathic pain.
Intrathecally administered alpha2-adrenergic receptor subtype-specific antagonists were used to determine which alpha2-adrenergic receptor subtype mediates the analgesic effect of intrathecally administered tizanidine in a chronic constriction injury (CCI) rat model of neuropathic pain. ⋯ The antagonist profile from the current study is most consistent with the theory that the alpha2B-adrenergic receptor subtype mediates the analgesic effect of intrathecally administered tizanidine on CCI-associated neuropathic pain.
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Journal of neurosurgery · Oct 2004
Reduction of neural adhesions by biodegradable autocrosslinked hyaluronic acid gel after injury of peripheral nerves: an experimental study.
Adhesion formation is a serious problem in peripheral nerve surgery, frequently causing dysfunction and pain. The authors aimed to develop an objective biomechanical method of quantifying nerve adhesions and to use this technique for the evaluation of the efficacy of an autocrosslinked hyaluronic acid (HA) gel as an antiadhesion therapy. ⋯ The biomechanical method described is an objective, quantitative technique for the assessment of nerve adherence to surrounding tissue. It will be a valuable tool in future studies on antiadhesion therapies. Furthermore, HA gel significantly reduces nerve adhesions after different types of nerve injuries.
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Journal of neurosurgery · Oct 2004
Acute alterations in microvascular basal lamina after subarachnoid hemorrhage.
Aneurysmal subarachnoid hemorrhage (SAH) causes acute and delayed ischemic brain injuries. The mechanisms of acute ischemic injury following SAH are poorly understood, although an acute increase in microvascular permeability has been noted. The integrity of cerebral microvessels is maintained in part by components of basal lamina: collagen IV, elastin, lamina, and so forth. Destruction of basal lamina components by collagenases and matrix metalloproteinases (MMPs), especially MMP-9, has been known to occur in other ischemic models. The authors assessed the integrity of cerebral microvasculature after acute SAH by examining collagen IV and MMP-9 levels and collagenase activity in the microvessels. ⋯ Results of this study demonstrated an acute loss of collagen IV from the cerebral microvasculature after SAH and indicated that MMP-9 contributes to this event. The loss of collagen IV might contribute to the known failure of the blood-brain barrier after SAH.