Journal of neurosurgery
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Continued advancement of the neurological surgery specialty depends on health policy engagement aimed at advocating for and protecting neurosurgeons and their patients. Dr. Ann R. ⋯ This brief historical vignette highlights the qualities of a pioneer advocate in neurosurgery who rose to be a successful leader while overcoming the challenges of practicing in a rural setting and within a historically male-dominated profession. Dr. Stroink's legacy serves as a beacon of inspiration, reminding us that through perseverance and advocacy we can pave the way for a brighter future in neurosurgery and beyond.
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Journal of neurosurgery · Jan 2025
Efficacy comparison and outcome predictors of GPi- and STN-targeted deep brain stimulation for Meige syndrome: a systematic review of individual patient data.
The aim of this study was to evaluate outcomes of deep brain stimulation (DBS) for Meige syndrome, compare the efficacy of globus pallidus internus (GPi) and subthalamic nucleus (STN) as targets, and identify potential outcome predictors. ⋯ DBS significantly improves motor symptoms and disability in patients with Meige syndrome, with GPi and STN targets providing comparable efficacy. The efficacy of DBS diminishes with longer disease duration, underscoring the importance of early intervention.
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Journal of neurosurgery · Jan 2025
Improved accuracy of delayed cerebral ischemia diagnosis with plasma nitric oxide synthase 3, nicotinamide adenine dinucleotide phosphate, and 8-iso-prostaglandin F2α.
The pathophysiology of delayed cerebral ischemia (DCI) is not fully elucidated. The lack of accurate diagnostic tools increases the probability of delayed diagnosis and timely treatment. The authors assessed the relationship of 8-iso-prostaglandin F2α (F2-IsoP) and oxidative stress biomarkers, nitric oxide synthase 3 (NOS3) and nicotinamide adenine dinucleotide phosphate (NADPH), with DCI after aneurysmal subarachnoid hemorrhage (aSAH). ⋯ The authors observed decreased antioxidant capacity in patients with DCI, which may be explained by increased F2-IsoP and decreased NADPH. Assessment of F2-IsoP, NOS3, and NADPH may improve the diagnostic accuracy of DCI. Further work is required to determine the role of F2-IsoP, NOS3, and NADPH in clinical practice and DCI pathophysiology.
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Journal of neurosurgery · Jan 2025
Auricular vagus nerve stimulation for mitigation of inflammation and vasospasm in subarachnoid hemorrhage: a single-institution randomized controlled trial.
Inflammation contributes to morbidity following subarachnoid hemorrhage (SAH). The authors of this study evaluate how applying noninvasive transauricular vagus nerve stimulation (taVNS) can target this deleterious inflammatory response following SAH and reduce the rate of radiographic vasospasm. ⋯ taVNS is a noninvasive method of neuro- and systemic immunomodulation. This trial supports the finding that taVNS following SAH can mitigate the inflammatory response, reduce radiographic vasospasm, and potentially improve functional and neurological outcomes.