Journal of neurosurgery
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Journal of neurosurgery · Jun 2010
Biography Historical ArticleWalter E. Dandy's contributions to vascular neurosurgery.
Although Walter E. Dandy (1886-1946) is appropriately credited with the first surgical clipping of an intracranial aneurysm in 1937--a procedure that established the modern field of vascular neurosurgery--his numerous other contributions to this specialty are not as well known. ⋯ In addition, Dandy performed the first surgical trapping of a cavernous internal carotid artery (ICA) aneurysm by clipping the supraclinoid ICA and ligating the cervical ICA, and he also executed the first intracranial surgical clipping of the ICA to treat a carotid-cavernous fistula. In this article the authors describe Dandy's contributions to the field of vascular neurosurgery.
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Journal of neurosurgery · Jun 2010
Effect of subthalamic deep brain stimulation on postural abnormality in Parkinson disease.
Parkinson disease (PD) is often accompanied by various postural abnormalities such as camptocormia (bent spine) or Pisa syndrome (lateral flexion). The authors studied the effect of subthalamic nucleus deep brain stimulation (STN DBS) on postural abnormality in patients with PD. ⋯ Postural abnormality in patients with PD could be ameliorated by STN DBS, and therefore surgery should be considered before irreversible spinal deformity develops.
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Journal of neurosurgery · Jun 2010
Long-term results of thalamic deep brain stimulation for essential tremor.
Deep brain stimulation (DBS) of the ventral intermediate nucleus of the thalamus (VIM) has proven to be efficacious in the treatment of essential tremor (ET). The authors report on long-term follow-up of a series of patients treated at 1 institution by 1 neurosurgeon. ⋯ Deep brain stimulation of the VIM is an efficient and safe treatment for ET. Tremor and handwriting improvements in long-term follow-up are stable. The patients' perception of their outcome is quite good. However, tolerance may develop in some patients requiring changes in stimulation parameters.
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Journal of neurosurgery · Jun 2010
Alleviation of off-period dystonia in Parkinson disease by a microlesion following subthalamic implantation.
A collision/implantation or microlesion effect is commonly described after subthalamic nucleus (STN) implantation for high-frequency stimulation, and this is presumed to reflect disruption of cells and/or fibers. Off-period dystonia, a frequent cause of disability in patients with advanced Parkinson disease, can lead to the need for surgical treatment. The authors assessed the early effect of this microlesion on off-period dystonia. ⋯ The author postulated that off-period dystonia alleviation may reflect both a microsubthalamotomy and micropallidotomy effect. They hypothesize, moreover, that the microlesion could play a role in the 6-month postoperative outcome.
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Journal of neurosurgery · Jun 2010
Case ReportsSpontaneous involution of Rathke cleft cysts: is it rare or just underreported?
Rathke cleft cysts (RCCs) are benign cystic lesions of the sella that arise from the remnants of Rathke pouch. Although most are asymptomatic, symptoms can result from mass effect and commonly include headache, endocrinopathy, or visual field disturbance. ⋯ Spontaneous involution of an RCC may be more common than the paucity of prior reports would suggest, especially because the natural history of both symptomatic and asymptomatic RCCs is poorly understood. The potential for spontaneous involution, together with the clinical course of the patients reported here, supports a conservative approach for patients with symptomatic RCCs presenting solely with headache.