Neurosurgery
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Case Reports
Ossification of the posterior longitudinal ligament of the lumbar spine: a case series.
Reports on ossification of the posterior longitudinal ligament (OPLL) of the lumbar spine have so far been limited. ⋯ Although the frequency of lumbar OPLL requiring surgical treatment was remarkably low, its clinical condition varies greatly among patients depending on the localization and degree of ossification. To achieve a better surgical outcome, precise diagnosis with computed tomography and an appropriate surgical approach are important.
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Although the outcome of epilepsy surgery changes with time, few studies have considered longitudinal changes after frontal lobe epilepsy (FLE) surgery. ⋯ The overall seizure outcome changes mostly during the first year. However, individual seizure status changes for up to 5 years. The outcome of late recurrence is favorable to AED adjustment.
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The role of extent of tumor resection in improving outcome for patients with glioblastoma multiforme (GBM) is still under debate. ⋯ Postoperative assessment of GBM volume seems to offer high intraobserver agreement, but low interobserver agreement. Using absolute RTV values to relate extent of tumor resection with survival may be unreliable. More research is needed before this method can be used as a valid end point for clinical studies. Computer-assisted tumor volume calculation may increase interobserver agreement in the future.
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Historical Article
Surgical treatment of trigeminal neuralgia: a history of early strides toward curing a "cancerous acrimony".
The pain of trigeminal neuralgia is considered one of the worst in human experience. Therefore, its treatment has been of special importance in the history of medicine and surgery. Long after physicians began prescribing various herbs and medication for trigeminal neuralgia, surgeons attempted to relieve it by cutting out parts of the nervous system they deemed responsible for the pain. ⋯ Harvey Cushing contributed the most to increase the safety of these neurosurgical techniques. Due to Dr Cushing's meticulous clinical observation and operative record keeping, we are able to selectively review his newly discovered patient records at Johns Hopkins and Peter Bent Brigham Hospitals and provide insight into the early history and evolution of trigeminal neuralgia surgery. We also review the contributions of other surgeons from the same period.
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The treatment of giant arteriovenous malformations (AVMs) remains a challenge in the neurosurgical field. Microsurgery is one of the most effective ways for eliminating giant cerebral AVMs. ⋯ Presurgical evaluation of every candidate and treatment choice is the determining factor in therapy for giant AVMs. For giant cerebral AVMs located superficially or not involving critical components, a good outcome can be expected through surgical resection. The obliteration and recurrence rates were satisfying, and the complication rate was acceptable.