Journal of neurosurgery
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Journal of neurosurgery · Jan 2007
Recognition and management of delayed hyponatremia following transsphenoidal pituitary surgery.
The goal of this study was to assess the incidence of symptomatic and occult hyponatremia in patients who had undergone transsphenoidal pituitary surgery. ⋯ Delayed hyponatremia occurs more frequently than was previously suspected in patients who have undergone transsphenoidal surgery, especially in female patients and those who have previously had transient DI. The majority of hyponatremic patients remain asymptomatic. Obtaining a serum sodium value on an outpatient basis 1 week after pituitary surgery is helpful in recognition, risk stratification, and subsequent intervention, and may prevent potentially serious complications.
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Journal of neurosurgery · Jan 2007
Neuroendoscopic treatment of multiloculated hydrocephalus in children.
The authors performed a retrospective analysis of data obtained in a series of 30 patients suffering from multiloculated hydrocephalus and treated endoscopically. The goal of the study was to evaluate the effectiveness of neuroendoscopic treatment as an alternative to the placement of multiple shunts to relieve intracranial hypertension, to simplify the shunt system, and to reduce the high rate of shunt revision. ⋯ Neuroendoscopic procedures are a valid alternative to shunt revision in the management of multiloculated hydrocephalus. Early diagnosis comprising close monitoring with high-resolution magnetic resonance imaging and early treatment are the keys of success.
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Journal of neurosurgery · Jan 2007
Case ReportsVisualization of the frontotemporal language fibers by tractography combined with functional magnetic resonance imaging and magnetoencephalography.
There is continuous interest in the monitoring of language function during tumor resection around the frontotemporal regions of the dominant hemisphere. The aim of this study was to visualize language-related subcortical connections, such as the arcuate fasciculus (AF) by diffusion tensor (DT) imaging-based tractography. ⋯ The combination of these techniques facilitated accurate identification of the location of the AF and verification of the language fibers.
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Journal of neurosurgery · Jan 2007
Case ReportsTransfemoral vein placement of a ventriculoatrial shunt. Technical note.
Acceptable cavities for the distal portion of a cerebrospinal fluid diversion shunt include the peritoneal, pleural, and atrial cavities. The authors report on a patient in whom placement into the peritoneal cavity failed, the pleural cavity was not an option, and access to the right atrium was not technically possible via standard cannulation techniques into the veins of the neck and shoulder regions. ⋯ Eight months postoperatively, the patient's condition was at baseline and there were no signs of shunt malfunction. This technique may prove useful when other measures have failed.
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Journal of neurosurgery · Jan 2007
Detection of the subthalamic nucleus in microelectrographic recordings in Parkinson disease using the high-frequency (> 500 hz) neuronal background. Technical note.
Accurate and fast localization of the subthalamic nucleus (STN) during intraoperative electrophysiological monitoring can improve the outcome of deep brain stimulation surgery. The authors show a simple method of detecting the STN that is based on an analysis of the high-frequency (> 500 Hz) background (HFB) activity of neurons. The HFB reflects multiunit spiking activity close to the recording electrode, and its characteristic profile, which is higher in the STN than in neighboring structures, and facilitates delineation of both the dorsal and ventral STN borders.