Journal of neurosurgery
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Journal of neurosurgery · Jul 2012
Long-term behavioral, electrophysiological, and neurochemical monitoring of the safety of an experimental antiepileptic implant, the muscimol-delivering Subdural Pharmacotherapy Device in monkeys.
The authors evaluated the extent to which the Subdural Pharmacotherapy Device (SPD), chronically implanted over the frontal cortex to perform periodic, localized muscimol-delivery/CSF removal cycles, affects overall behavior, motor performance, electroencephalography (EEG) activity, and blood and CSF neurochemistry in macaque monkeys. ⋯ Long-term, periodic, transmeningeal muscimol delivery with the SPD is essentially a safe procedure. If further improved and successfully adapted for use in humans, the SPD can be used for the treatment of intractable focal neocortical epilepsy affecting approximately 150,000 patients in the US.
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Journal of neurosurgery · Jul 2012
Case ReportsAnnual rupture risk of growing unruptured cerebral aneurysms detected by magnetic resonance angiography.
In this paper, the authors' goals were to clarify the characteristics of growing unruptured cerebral aneurysms detected by serial MR angiography and to establish the recommended follow-up interval. ⋯ Despite the relatively short period, the annual rupture risk of growing unruptured cerebral aneurysms detected by MR angiography was not as low as previously reported. Surgical or endovascular treatment can be considered if aneurysm growth is detected during the follow-up period.
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Journal of neurosurgery · Jul 2012
Case ReportsA new strategic neurosurgical planning tool for brainstem cavernous malformations using interactive computer graphics with multimodal fusion images.
In this study, the authors used preoperative simulation employing 3D computer graphics (interactive computer graphics) to fuse all imaging data for brainstem cavernous malformations. The authors evaluated whether interactive computer graphics or 2D imaging correlated better with the actual operative field, particularly in identifying a developmental venous anomaly (DVA). ⋯ The authors report a new method for automatic registration of preoperative imaging data from CT, MRI, and 3D rotational angiography for reconstruction into 1 computer graphic. The diagnostic rate of DVA associated with brainstem cavernous malformation was significantly better using interactive computer graphics than with 2D images. Interactive computer graphics was also useful in helping to plan the surgical access corridor.
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Journal of neurosurgery · Jul 2012
Utility of VasoCT in the treatment of intracranial aneurysm with flow-diverter stents.
The small size and tortuous anatomy of intracranial arteries require that flow-diverter stents in the intracranial vasculature have a low profile, high flexibility, and excellent trackability. However, these features limit the degree of radiopacity that can be incorporated into the stents. Visualization of these stents and the degree of stent deployment using conventional radiographic techniques is suboptimal. To overcome this drawback, the authors used a new combined angiography/CT suite that uses flat-panel detector technology for higher resolution angiography. ⋯ The authors found that VasoCT provides clear visualization of flow-diverter stents. The images obtained both intraarterially and intravenously are very promising. The initial results provide a high confidence and reproducibility rate for further utilization of this new technique.
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Journal of neurosurgery · Jul 2012
Long-term benefits in quality of life after unilateral thalamic deep brain stimulation for essential tremor.
The goal of this study was to evaluate short- and long-term benefits in quality of life (QOL) after unilateral deep brain stimulation (DBS) for essential tremor (ET). ⋯ Unilateral thalamic stimulation significantly reduces ET and improves ADL scores for up to 12 years after surgery, as measured by the TRS. The PDQ-39 total score and the domains of ADL, emotional well-being, and stigma were significantly improved up to 7 years. Although scores were improved compared with presurgery, other than stigma, these benefits did not remain significant at the longest (up to 12 years) follow-up, probably related in part to changes due to aging and comorbidities.