Journal of neurosurgery
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Journal of neurosurgery · Oct 2018
Early outcomes after intrathecal baclofen therapy in ambulatory patients with multiple sclerosis.
Multiple sclerosis (MS) is a chronic autoimmune disease that causes demyelination and axonal loss. Walking difficulties are a common and debilitating symptom of MS; they are usually caused by spastic paresis of the lower extremities. Although intrathecal baclofen (ITB) therapy has been reported to be an effective treatment for spasticity in MS, there is limited published evidence regarding its effects on ambulation. The goal of this study was to characterize ITB therapy outcomes in ambulatory patients with MS. ⋯ In this retrospective study, the authors found that ITB therapy is effective in reducing spasticity and related symptoms in ambulatory patients with MS. Because the use of ITB therapy is increasing in ambulatory patients with MS, randomized, prospective studies are important to help provide a more useful characterization of the effects of ITB therapy on ambulation.
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Journal of neurosurgery · Oct 2018
Serum glucose/potassium ratio as a clinical risk factor for aneurysmal subarachnoid hemorrhage.
Aneurysmal subarachnoid hemorrhage (SAH) can result in poor outcomes, and biomarkers for predicting poor prognosis have not yet been established. The aim of this study was to clarify the significance of the serum glucose/potassium ratio for predicting the prognosis of aneurysmal SAH. ⋯ In this study, the serum glucose/potassium ratio of patients with aneurysmal SAH at admission was significantly correlated with H-K grade and GOS score at discharge. Therefore, this ratio was useful for predicting prognosis of aneurysmal SAH, especially in severe cases.
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Journal of neurosurgery · Oct 2018
Rupture prediction of intracranial aneurysms: a nationwide matched case-control study of hemodynamics at the time of diagnosis.
The authors used computer simulation to investigate the hemodynamics in 36 unruptured aneurysms on the first day the lesions were discovered; 12 of them later ruptured. Knowledge about any differences in hemodynamics at this early stage improves predictions about which patients will get a subarachnoid hemorrhage-a dangerous bleeding in the brain-and helps decide which patients should be treated in advance to avoid the bleeding.
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Journal of neurosurgery · Oct 2018
Case ReportsEfficacy of limited hippocampal radiofrequency thermocoagulation for mesial temporal lobe epilepsy.
Radiofrequency thermocoagulation (RFTC), which has been developed for drug-resistant epilepsy patients, involves less brain tissue loss due to surgery, fewer surgical adverse effects, and generally good seizure control. This study demonstrates the effectiveness of RFTC performed at limited hippocampal locations. ⋯ The study results confirm that limited RFTC provides a more effective surgery with similar seizure control but fewer complications than resective surgery for drug-resistant MTLE patients.
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Journal of neurosurgery · Oct 2018
A computational fluid dynamics simulation framework for ventricular catheter design optimization.
In this research an optimization methodology and 3D computational fluid dynamics algorithm were coupled to reach an important design objective for ventricular catheters: uniform inlet flow distribution. The optimized catheter design presented significantly improves on previous designs explored in the literature and on standard catheter designs used clinically. The automated, iterative fluid simulation framework described in this work can be used to rapidly explore design parameter influence on other flow-related objectives in the future.