Journal of neurosurgery
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Journal of neurosurgery · May 2015
Review Comparative StudyDeep brain stimulation versus anterior capsulotomy for obsessive-compulsive disorder: a review of the literature.
Obsessive-compulsive disorder (OCD) is a chronic and debilitating psychiatric condition. Traditionally, anterior capsulotomy (AC) was an established procedure for treatment of patients with refractory OCD. Over recent decades, deep brain stimulation (DBS) has gained popularity. ⋯ Anterior capsulotomy is an efficient procedure for refractory OCD. Deep brain stimulation in the VC/VS and NAcc area is an emerging and promising therapy. The current popularity of DBS over ablative surgery for OCD is not due to nonefficacy of AC, but possibly because DBS is perceived as more acceptable by clinicians and patients.
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Journal of neurosurgery · May 2015
Randomized Controlled Trial Comparative StudyProspective randomized study comparing clinical, functional, and aesthetic results of minipterional and classic pterional craniotomies.
OBJECT The object of this study was to compare the clinical, functional, and aesthetic results of 2 surgical techniques, pterional (PT) and minipterional (MPT) craniotomies, for microsurgical clipping of anterior circulation aneurysms. METHODS Fifty-eight patients with ruptured and unruptured anterior circulation aneurysms were enrolled into a prospective randomized study. The first group included 28 patients who underwent the MPT technique, and the second group comprised 30 patients who underwent the classic PT craniotomy. ⋯ CONCLUSIONS Minipterional craniotomy provides clinical results similar to those of the PT technique. Moreover, it provides better cosmetic results. It can be used safely and effectively to surgically treat aneurysms of the anterior circulation instead of the PT approach.
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Journal of neurosurgery · May 2015
Randomized Controlled TrialLaparoscopically assisted ventriculoperitoneal shunt placement: a prospective randomized controlled trial.
OBJECT In ventriculoperitoneal (VP) shunt surgery, laparoscopic assistance can be used for placement of the peritoneal catheter. Until now, the efficacy of laparoscopic shunt placement has been investigated only in retrospective and nonrandomized prospective studies, which have reported decreased distal shunt dysfunction rates in patients undergoing laparascopic placement compared with mini-laparotomy cohorts. In this randomized controlled trial the authors compared rates of shunt failure in patients who underwent laparoscopic surgery for peritoneal catheter placement with rates in patients who underwent traditional mini-laparotomy. ⋯ Infections occurred in 1 patient in the laparoscopic group and 3 in the mini-laparotomy group. The mean durations of surgery and hospitalization were similar in the 2 groups. CONCLUSIONS While overall shunt failure rates were similar in the 2 groups, the use of laparoscopic shunt placement significantly reduced the rate of distal shunt failure compared with mini-laparotomy.
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Journal of neurosurgery · May 2015
Case Reports Comparative StudyCharacterization of radiation-induced cavernous malformations and comparison with a nonradiation cavernous malformation cohort.
The objective of this study was to characterize the clinical features of radiation-induced cavernous malformations (RICMs). ⋯ In this patient population, RICMs occurred within the radiation port approximately 12 years after radiation treatment. Compared with nonradiation CMs, RICMs were more likely to occur as multiple CMs, to present at a younger age, and were at least as likely to cause symptomatic hemorrhage.
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Journal of neurosurgery · May 2015
Case ReportsJostent covered stent placement for emergency reconstruction of a ruptured internal carotid artery during or after transsphenoidal surgery.
Internal carotid artery (ICA) rupture during transsphenoidal surgery (TSS) is an extremely difficult complication to treat. This study aimed to evaluate the immediate and long-term outcomes of covered stent placement for emergency reconstruction of ruptured ICAs during or after TSS. ⋯ Covered stents appear to be a safe and effective option for emergency reconstruction of ruptured ICAs during or after TSS.