Neurosurgery
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A preliminary study of subthalamic nucleus (STN) stimulation was performed to determine its applicability for the treatment of gait and postural disturbances in Parkinson's disease. ⋯ Our findings showed that STN stimulation effectively alleviates freezing gait and improves walking to its status during the preoperative on-drug phase and can be applied for treatment of Parkinson's disease patients with these symptoms.
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Case Reports
Symptomatic spinal epidural lipomatosis after local epidural corticosteroid injections: case report.
Spinal epidural lipomatosis, which causes symptomatic compression of neural elements, is a well known but uncommon complication of Cushing's syndrome. Spinal epidural lipomatosis has been reported frequently in association with chronic systemic corticosteroid therapy, but thus far only one case has been attributed to local epidural corticosteroid injections. ⋯ This case should alert clinicians that epidural lipomatosis, which causes symptomatic thecal sac compression, is a possible complication, not only of systemic glucocorticoid therapy, but also of local epidural corticosteroid injections.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative study of propofol and midazolam effects on somatosensory evoked potentials during surgical treatment of scoliosis.
Studies of the effects on lower-limb cortical somatosensory evoked potentials (CSEP) during total intravenous anesthesia are sparse for propofol and are lacking for midazolam. This study was designed to compare the effects of propofol and midazolam on CSEP under total intravenous anesthesia during intraoperative monitoring for surgical treatment of scoliosis. ⋯ This study demonstrates the appropriate use of either propofol or midazolam in scoliosis monitoring. Preoperative small-amplitude CSEPs might favor the use of propofol anesthesia.
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Comparative Study
Direct and combined revascularization in pediatric moyamoya disease.
Surgical revascularization of moyamoya disease can improve neurological outcomes, compared with the natural history of the disease or the results of medical treatment. Controversy exists regarding whether direct or indirect revascularization yields better outcomes. This study involves a single-center experience with direct anastomosis and is the first North American series using direct revascularization for pediatric patients with moyamoya disease. ⋯ Surgical revascularization by direct anastomosis in pediatric patients is technically feasible, is well tolerated, and can improve the progressive natural history, the angiographic appearance, and the cerebral blood flow abnormalities associated with the disease. Direct revascularization has the advantage of providing immediate and high-flow revascularization and is particularly useful for patients who have experienced failure of previous indirect revascularization procedures.
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The discovery of the arachnoid membrane is a relatively recent advance. Ancient anatomists noted the presence of the dura mater and pia mater, but the intervening arachnoid membrane was left undescribed. It was not until the 17th century that anatomists discovered a layer separating the pia mater from the dura mater and named this cobweb-like layer the "arachnoid." Arachnoid means "spider-like" and has an interesting etymology that can be traced to the ancient Greek myth of Arachne.