Neurosurgery
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Biography Historical Article
Functional anatomy of the spine by Avicenna in his eleventh century treatise Al-Qanun fi al-Tibb (The Canons of Medicine).
The history of spinal surgery is an important part of the spine-related sciences. The development of treatment strategies for spine-related disorders is acquired from the Western literature. In this article, an Eastern physician, Ibn Sina, who is known as Avicenna in the West, and his treatise, Al-Qanun fi al-Tibb (the Canons of Medicine), are presented. Eight chapters of this book regarding the functional neuroanatomy of the spine were reviewed and are presented to give insight into the development of the understanding of spinal anatomy and biomechanics.
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The objective of this study was to determine the nationwide, population-based incidences of intracranial gliomas and meningiomas (of all grades) during 55 years of monitoring in Denmark. ⋯ Based on complete notification to the Danish Cancer Registry, the overall incidences of intracranial gliomas and meningiomas increased during a 55-year period. These increases were observed for all age groups and both sexes. These increases could be explained on the basis of improved diagnoses of these tumors. For gliomas, a maximal annual incidence of approximately 4 cases/100,000 population (World Standard Population) was observed in Denmark at the end of the study period, suggesting that the effects of improved diagnostic tools have reached their maximum with respect to this tumor type. The same was not observed for the incidence of meningiomas, suggesting that perhaps underreporting is still present.
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Microvascular decompression (MVD) is associated with low mortality and morbidity rates at specialized centers, but many MVD procedures are performed outside such centers. We studied short-term end points after MVD in a national hospital discharge database sample. ⋯ Although most MVD procedures in the United States are performed at low-volume centers, mortality rates remain low. Morbidity rates are significantly lower at high-volume hospitals and with high-volume surgeons.
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Randomized Controlled Trial Clinical Trial
Long-term electrical capsular stimulation in patients with obsessive-compulsive disorder.
Because of the irreversibility of lesioning procedures and their possible side effects, we studied the efficacy of replacing bilateral anterior capsulotomy with chronic electrical capsular stimulation in patients with severe, long-standing, treatment-resistant obsessive-compulsive disorder. ⋯ These observations indicate that capsular stimulation reduces core symptoms 21 months after surgery in patients with severe, long-standing, treatment-refractory obsessive-compulsive disorder. The stimulation elicited changes in regional brain activity as measured by functional magnetic resonance imaging and positron emission tomography.
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Review Case Reports
Midaortic syndrome and subarachnoid hemorrhage associated with ruptured middle cerebral artery aneurysm: case report and review of the literature.
We describe the presentation, screening, management, and clinical outcome of a 21-year-old man who sought care for a ruptured middle cerebral artery (MCA) aneurysm and midaortic syndrome (MAS). Only three cases of MAS and intracranial aneurysm rupture have previously been described in the literature. ⋯ Our patient is the first reported case of ruptured MCA aneurysm with MAS in an adult. The most important problem in the management of MAS associated with ruptured intracranial aneurysm is medically intractable hypertension, which may markedly increase the incidence of rebleeding. It is hard to achieve normotension unless the narrowed aorta and its branches are dilated. For these reasons, MAS should be considered in patients with medically intractable hypertension associated with ruptured intracranial aneurysm.