Journal of neurosurgery
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Journal of neurosurgery · Jan 2014
Hypoglossal-facial nerve "side"-to-side neurorrhaphy for persistent incomplete facial palsy.
Hypoglossal-facial nerve neurorrhaphy is a widely used method for treating complete facial palsy. However, the classic surgical procedure using a "side"-to-end neurorrhaphy is not suitable for incomplete facial palsy (IFP), because sectioning of the facial nerve for neurorrhaphy compromises remnant axons and potential spontaneous reinnervation. For the treatment of persistent IFP, the authors investigated in rats a modified method using hypoglossal-facial nerve "side"-to-side neurorrhaphy. ⋯ This study demonstrates that hypoglossal-facial nerve "side"-to-side neurorrhaphy with a predegenerated nerve graft can lead to rapid functional benefits for persistent IFP without compromising the remnants of facial axons, thus providing a proof-of-feasibility for further studies in humans.
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Journal of neurosurgery · Jan 2014
Case ReportsProximal subcutaneous migration of the distal end of a ventriculoperitoneal shunt presenting with recurrent cerebrospinal fluid galactorrhea.
The authors report an unusual case of recurrent proximal migration of the distal end of a ventriculoperitoneal shunt catheter presenting as CSF galactorrhea. The authors review the pertinent literature and discuss the possible causes as well as techniques to prevent a similar occurrence.
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Journal of neurosurgery · Jan 2014
Factors neurosurgery candidates use when choosing a residency program.
Many factors affect an applicant's decision when selecting a residency program. While some issues are likely important to all applicants, others may be specific to, or weighed differently by, those applying to certain specialties. In an effort to better understand how applicants to neurosurgery programs make decisions about relative rank, the authors created a survey to identify the program characteristics thought most important by applicants. ⋯ Applicants for neurosurgical training choose a program for reasons similar to those given by applicants to other specialties. Neurosurgery applicants seem marginally more interested in an emphasis on academics and research and slightly less concerned with a program's location, but overall, the differences appear minimal. The interview process is very important, and contact by a representative after the interview also seems significant in applicants' decision making. By recognizing what applicants think is important in choosing a residency, programs can more effectively recruit residents and more efficiently use faculty time and department resources.
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Journal of neurosurgery · Jan 2014
Risks of common complications in deep brain stimulation surgery: management and avoidance.
Deep brain stimulation (DBS) surgery is increasingly prominent in the treatment of various disorders refractory to medication. Despite the procedure's efficacy, the community at large continues to be hesitant about presumed associated risks. The main object of this study was to assess the incidence of various surgical complications occurring both during and after DBS device implantation in a large population of patients with movement disorders in an effort to better quantify patient risk, define management plans, and develop methods for risk avoidance. A second aim was to corroborate the low procedural complication risk of DBS reported by others, which in light of the procedure's efficacy is needed to promote its widespread acceptance. ⋯ The authors confirmed that the overall risk of both procedure- and hardware-related adverse events is acceptably low. They offer advice on how to avoid the most common complications.