Journal of neurosurgery
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Journal of neurosurgery · Mar 2013
The effect of exercise on mobilization of hematopoietic progenitor cells involved in the repair of sciatic nerve crush injury.
Object Mobilization of hematopoietic progenitor cells (HPCs) from bone marrow involved in the process of peripheral nerve regeneration occurs mostly through deposits of CD34(+) cells. Treadmill exercise, with either differing intensity or duration, has been shown to increase axon regeneration and sprouting, but the effect of mobilization of HPCs on peripheral nerve regeneration due to treadmill exercise has not yet been elucidated. Methods Peripheral nerve injury was induced in Sprague-Dawley rats by crushing the left sciatic nerve using a vessel clamp. ⋯ In addition, deposits of CD34(+) cells in crushed nerves paralleled the elevated expressions of von Willebrand factor, isolectin B4, and vascular endothelial growth factor. Conclusions Bone marrow HPCs, especially CD34(+) cells, were able to be mobilized by low-intensity treadmill exercise, and this effect paralleled the significant expression of angiogenesis factors. Treadmill exercise stimulation of HPC mobilization during peripheral nerve regeneration could be used as a therapy in human beings.
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Journal of neurosurgery · Mar 2013
Identification of venous sinus, tumor location, and pial supply during meningioma surgery by transdural indocyanine green videography.
Indocyanine green (ICG) videography is commonly used in the neurosurgical field for minimally invasive neurosurgery. The aim of this study was to evaluate a new intraoperative imaging modality by performing transdural ICG videography during surgery for meningiomas. ⋯ Prior to opening of the dura mater, transdural ICG videography was used successfully to visualize the dural attachment of meningiomas and the venous sinus, resulting in safe and appropriate dural opening. The diminishment of the total and partial eclipse signs may represent significant feeding from the intracranial arteries and a tendency to bleed during resection.
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Journal of neurosurgery · Mar 2013
Decreasing ventricular infections through the use of a ventriculostomy placement bundle: experience at a single institution.
Ventricular infection after ventriculostomy placement carries a high mortality rate. Responding to ventriculostomy infection rates, a multidisciplinary performance improvement team was formed, a comprehensive protocol for ventriculostomy placement was developed, and the efficacy was evaluated. ⋯ Bundle implementation including an antimicrobial-impregnated catheter dramatically decreased EVD-related infections. Training and situational awareness of appropriate practice, assisted by the checklist, plus use of the antibiotic-impregnated catheter resulted in sustained reduction in ventriculitis.
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Journal of neurosurgery · Mar 2013
Endoscopic endonasal surgery for giant pituitary adenomas: advantages and limitations.
Giant pituitary adenomas (> 4 cm in maximum diameter) represent a significant surgical challenge. Endoscopic endonasal surgery (EES) has recently been introduced as a treatment option for these tumors. The authors present the results of EES for giant adenomas and analyze the advantages and limitations of this technique. ⋯ Endoscopic endonasal surgery provides effective initial management of giant pituitary adenomas with favorable results compared with traditional microscopic transsphenoidal and transcranial approaches.
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Journal of neurosurgery · Mar 2013
Limbic system surgery for treatment-refractory obsessive-compulsive disorder: a prospective long-term follow-up of 64 patients.
Obsessive-compulsive disorder (OCD) is a common and disabling psychiatric illness, and in a significant proportion of patients with OCD the disease is refractory to conventional pharmacotherapy and psychotherapy. For more than half a century, patients with severe, treatment-resistant OCD have been treated with stereotactic limbic system lesions, including dorsal anterior cingulotomy. The authors present their results describing the efficacy and durability of limbic system surgery for OCD, characterizing a large cohort of patients treated at a single institution with a mean follow-up of more than 5 years. ⋯ Limbic system surgery based on initial cingulotomy offers a durable and effective treatment option for appropriately selected patients with severe OCD who have not responded to conventional pharmacotherapy or psychotherapy.