Neurosurgery
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Comparative Study
Development of neuronal networks from single stem cells harvested from the adult human brain.
It was long held as an axiom that new neurons are not produced in the adult human brain. More recent studies, however, have identified multipotent cells whose progeny express glial or neuronal markers. This discovery may lead to new therapeutic strategies against central nervous system disorders by transplanting stem cells that have been propagated in vitro. Still, it is not known whether stem cells from the adult human brain retain the potential to mature into neurons that integrate and communicate in a network. ⋯ Neural stem cells harvested from the adult human brain retain the potential to mature into fully differentiated neurons that integrate and communicate by synapses. This opens a possible future scenario of autotransplantation, in which stem cells are harvested from small biopsies of the ventricular wall and propagated in vitro before transplantation.
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Meta Analysis Comparative Study
Carotid angioplasty with or without stent placement versus carotid endarterectomy for treatment of carotid stenosis: a meta-analysis.
Carotid angioplasty with or without stent placement (CAS) has been proposed as an alternative method to carotid endarterectomy (CEA) for treatment of carotid stenosis. Small randomized trials have evaluated the comparative efficacy of both methods; however, definitive evidence is lacking. ⋯ The 30-day stroke and death rates associated with CAS and CEA were not significantly different. Lower rates of myocardial infarction and cranial nerve injury were observed with CAS compared with CEA.
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Comparative Study Clinical Trial
Usefulness of the Neuroform stent for the treatment of cerebral aneurysms: results at initial (3-6-mo) follow-up.
The Neuroform microstent, a flexible, self-expanding, nitinol stent specifically designed for use in the cerebral vasculature, became available in North America for aneurysm treatment in November 2002. The present report details our experience with the Neuroform stent over the past 2 years, with an emphasis on evolving treatment strategies and treatment durability at initial (3-6 mo) follow-up. ⋯ The Neuroform stent facilitates adequate embolization of complex cerebral aneurysms, which would not otherwise be amenable to endovascular therapy. Initial follow-up data indicate favorable progressive thrombosis and recanalization rates for aneurysms after Neuroform stent-assisted embolization. These advantages of stenting were most evident for small aneurysms with wide necks.
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Comparative Study Clinical Trial
Depression in relation to survival among neurosurgical patients with a primary brain tumor: a 5-year follow-up study.
The adverse impact of depression in relation to survival among cancer patients is currently a subject of great interest in research. In a 5-year follow-up study, we investigated the association of depression with survival of patients with a primary brain tumor. ⋯ Preoperative depression seemed to be a significant prognostic factor for worse survival in low-grade glioma patients. In clinical practice, an evaluation of depression among brain tumor patients by structured and standardized diagnostic methods is needed to distinguish the patients whose depression actually needs treatment. The effective treatment of clinical depression among brain tumor patients and the impact of treatment on the patients' chances of survival should be a focus of future research.
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Comparative Study
Functional outcome after central corpectomy in poor-grade patients with cervical spondylotic myelopathy or ossified posterior longitudinal ligament.
We studied the long-term functional outcome in poor-grade patients (Nurick Grades 4 and 5) with cervical spondylotic myelopathy (CSM) or ossified posterior longitudinal ligament after central corpectomy (CC). We sought to determine whether there were any prognostic factors that could predict functional outcome in these patients. ⋯ More than three-fourths of patients with poor-grade CSM improve in their functional status after CC, with nearly 24% of patients obtaining a cure. Because patients with a duration of myelopathic symptoms of 12 months or less had the best functional outcome, early decompressive surgery should be offered to patients with poor-grade CSM.