Journal of neurosurgery
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Journal of neurosurgery · Feb 2020
Case ReportsUrinary incontinence following deep brain stimulation of the globus pallidus internus: case report.
Deep brain stimulation (DBS) is a well-established therapy for patients with advanced Parkinson's disease (PD), dystonia, and other movement disorders. In contrast to the strong positive effects that have been documented for motor symptoms, the effects of DBS on nonmotor symptoms have not been fully elucidated. ⋯ The urinary incontinence disappeared when stimulation was turned off, and reemerged after it was turned on again. After activation of a more dorsal contact in the left electrode, the patient's urinary dynamics returned to normal.
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Journal of neurosurgery · Feb 2020
ReviewReporting trends of p values in the neurosurgical literature.
The objective of this study was to evaluate the trends in reporting of p values in the neurosurgical literature from 1990 through 2017. ⋯ Trends in reporting of p values and the distribution of p values suggest publication bias remains in the neurosurgical literature.
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Journal of neurosurgery · Feb 2020
Intraoperative 3D ultrasound-guided resection of diffuse low-grade gliomas: radiological and clinical results.
Extent of resection (EOR) and residual tumor volume are linked to prognosis in low-grade glioma (LGG) and there are various methods for facilitating safe maximal resection in such patients. In this prospective study the authors assess radiological and clinical results in consecutive patients with LGG treated with 3D ultrasound (US)-guided resection under general anesthesia. ⋯ Three-dimensional US-guided LGG resections under general anesthesia are safe and HRQoL is preserved in most patients. Effectiveness in terms of EOR appears to be consistent with published studies using other advanced neurosurgical tools. Avoiding intraoperative vascular injury is a key factor for achieving good functional outcome.
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Journal of neurosurgery · Feb 2020
Revascularization surgery for symptomatic non-moyamoya intracranial arterial stenosis or occlusion.
Previous trials rejected a role of extracranial-to-intracranial bypass surgery for managing symptomatic atheromatous disease. However, hemodynamic insufficiency may still be a rationale for surgery, provided the bypass can be performed with low morbidity and patency is robust. ⋯ Prophylactic arterial pedicle bypass surgery for anterior circulation ischemia is associated with high graft patency and low stroke and surgical complication rates. Higher risks are associated with acute procedures, typically for posterior circulation pathology and requiring VIGs. A carefully selected subgroup of individuals with hemodynamic insufficiency and ischemic symptoms is likely to benefit from cerebral revascularization surgery.
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Journal of neurosurgery · Feb 2020
Local tumor response and survival outcomes after combined stereotactic radiosurgery and immunotherapy in non-small cell lung cancer with brain metastases.
Concurrent use of anti-PD-1 therapies with stereotactic radiosurgery (SRS) have been shown to be beneficial for survival and local lesional control in melanoma patients with brain metastases. It is not known, however, if immunotherapy (IT) confers the same outcome advantage in lung cancer patients with brain metastases treated with SRS. ⋯ Unlike patients with melanoma, patients with NSCLC with brain metastases undergoing SRS showed no significant benefit-either in terms of survival or total amount of lesional response-when anti-PD-1 therapies were used. However, in lesions with volume > 500 mm3, combining SRS with IT may result in a faster and better volumetric response which may be particularly beneficial in lesions causing mass effect or located in neurologically critical locations.