Neurosurgery
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Biography Historical Article
Five early accounts of phantom limb in context: Paré, Descartes, Lemos, Bell, and Mitchell.
PHANTOM LIMB WAS described long before American physician and surgeon Silas Weir Mitchell coined the term and drew attention to the disorder in the 1860s. The early descriptions of Ambroise Paré, René Descartes, Aaron Lemos, Charles Bell, and then Mitchell of this strange consequence of amputation are presented in historical and cultural context. ⋯ They also differed when it came to explaining and dealing with these illusory sensations. The rich history of phantom limbs can begin to be appreciated by viewing the contributions of these individuals in perspective and by realizing that their writings represent only a fraction of what was published about phantom limbs more than 130 years ago.
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Biography Historical Article
From microscopic to astronomic, the legacy of Carl Zeiss.
IN 1846, CARL ZEISS established a workshop to make lenses for microscopes, cameras, binoculars, and astronomical observatories. He was a master craftsman and was intolerant of any flaw, destroying microscopes with only minor inaccuracies. His relentless pursuit of perfection brought him into contact with a brilliant physicist, Ernst Abbe. ⋯ Their company came to be known not only for exquisite technical standards but also for labor relations that were and remain progressive. The development of microneurosurgery was aided by the active participation of Carl Zeiss, Inc. The history of this company provides a lesson in the power of entrepreneurship and the benefits to humanity that can accrue from a fruitful partnership between medical science and industry.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Automated, patient-interactive, spinal cord stimulator adjustment: a randomized controlled trial.
Programmable, multicontact, implanted stimulation devices represent an important advance in spinal cord stimulation for the management of pain. They facilitate the technical goal of covering areas of pain by stimulation-evoked paresthesiae. Adjustment after implantation requires major investments of time and effort, however, if the capabilities of these devices are to be used to full advantage. The objective of maximizing coverage should be met while using practitioners' time efficiently. ⋯ Automated, patient-interactive adjustment of implanted spinal cord stimulators is significantly more effective and more efficient than traditional manual methods of adjustment. It offers not only improved clinical efficacy but also potential cost savings in extending implanted battery life. It has the additional potential advantages of standardization, quality control, and record keeping, to facilitate clinical research and patient care. It should enhance the clinical application of spinal cord stimulation for the treatment of chronic intractable pain.
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Review Case Reports
Isolated trigeminal nerve sarcoid granuloma mimicking trigeminal schwannoma: case report.
Sarcoidosis most commonly presents as a systemic disorder. Infrequently, sarcoidosis can manifest itself in the central nervous system, with granulomas involving the leptomeninges and presenting with facial nerve weakness. Sarcoid of the trigeminal nerve is exceedingly rare and can mimic trigeminal schwannoma. We review the literature on sarcoid granulomas of the trigeminal nerve and compare their radiological features with the more common schwannoma. ⋯ The differential diagnosis of contrast-enhancing lesions in the lateral wall of the cavernous sinus should include inflammatory conditions such as sarcoidosis. We recommend that surgery for biopsy or decompression be used only for those patients in whom a diagnosis cannot be confirmed with noninvasive testing. If surgery is performed, intraoperative frozen pathology is very useful in guiding the extent of resection.
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Meta Analysis Comparative Study
Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms: a meta-analysis.
To compare a novel diagnostic radiological technique, computed tomographic angiography (CTA), with the standard method, namely digital subtraction angiography (DSA), in the diagnosis of cerebral aneurysms. ⋯ On the basis of this meta-analysis, DSA remains the standard method. However, many who use CTA have reported it to be as good as or better than DSA in the diagnosis and treatment of cerebral aneurysms, as well as being of less risk and discomfort to their patients and easier and less expensive to perform.