Journal of neurosurgery
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Journal of neurosurgery · Sep 2013
Comparative StudyComplement polymorphisms and cognitive dysfunction after carotid endarterectomy.
The role of genetic polymorphisms in the neurological outcome of patients after carotid endarterectomy (CEA) remains unclear. There are single nucleotide polymorphisms (SNPs) that predispose patients to postoperative cognitive dysfunction (CD). We aim to assess the predictability of three complement cascade-related SNPs for CD in patients having CEAs. ⋯ The presence of a deleterious allele in the C5 and CFH SNPs may predispose patients to exhibit CD after CEA. This finding supports previous data demonstrating that the complement cascade system may play an important role in the development of CD. These findings warrant further investigation.
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Journal of neurosurgery · Sep 2013
Case ReportsLimitations of nerve repair of segmental defects using acellular conduits.
The authors present the case of a 20-year-old man who, 3 months after his initial injury, underwent repair of a 1.7-cm defect of the ulnar nerve at the wrist; repair was performed with an acellular nerve allograft. Given the absence of clinical or electrophysiological recovery at 8 months postrepair, the patient underwent reexploration, excision of the "regenerated cable," and rerepair of the ulnar nerve with sural nerve autografts. ⋯ At the 6- and 12-month follow-ups of the sural nerve graft repair, clinical and electrophysiological evidence of both sensory and motor reinnervation of the ulnar nerve and associated hand muscles was demonstrated. In this report, the authors describe a single case of failed acellular nerve allograft and correlate the results with basic science and human studies reporting length and diameter limitations in human nerve repair utilizing grafts or conduits devoid of viable Schwann cells.
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Journal of neurosurgery · Sep 2013
Comparative StudyBiomechanical performance of leather and modern football helmets.
With the increased national concern about concussions in football, recent research has focused on evaluating the impact performance of modern football helmets. Specifically, this technical note offers a biomechanical analysis of classic leather helmets compared with modern helmets. ⋯ The resulting head acceleration was used to assess the risk of concussion for each drop test. The results of this analysis demonstrate that modern helmets are significantly and substantially superior to leather helmets in all impact scenarios, and that notable differences exist among modern helmets.
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The authors commemorate the life and career of Dr. Ladislau Steiner, one of the world's most highly regarded neurosurgeons, from Stockholm and Charlottesville, Virginia, who has died at age 92. They review the events of Dr. ⋯ Steiner had a second career as head of the Lars Leksell Gamma Knife Center at the University of Virginia in Charlottesville. The authors recall their own long association with Dr. Steiner and celebrate his contributions to the field of neurosurgery.
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Journal of neurosurgery · Sep 2013
Biography Historical ArticleCharles Stent and the mystery behind the word "stent".
Stents have come to be well-known devices and are being used widely in numerous branches of medicine. It is intriguing that the word "stent" actually derives from the name of a dentist, Charles Stent, who developed a material to obtain dental impressions. ⋯ Intracranial stenting is a relatively new and rapidly developing field that came into being not more than 12 years ago. The authors describe the life and works of Charles Stent, discuss the possible origins of the word stent, and discuss how intravascular and intracranial stenting came into existence.