Neurosurgery
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Restoration of elbow extension has not been considered of much importance regarding functional outcomes in brachial plexus surgery; however, the flexion of the elbow joint is only fully effective if the motion can be stabilized, what can be achieved solely if the triceps brachii is coactivated. To present a novel nerve transfer of a healthy motor fascicle from the ulnar nerve to the nerve of the long head of the triceps to restore the elbow extension function in brachial plexus injuries involving the upper and middle trunks. ⋯ The attempted nerve transfer was effective for restoration of elbow extension in primary brachial plexus surgery; however, it should be selected only for cases in which other reliable donor nerves were used to restore elbow flexion.
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Ventriculoperitoneal shunting remains the most widely used neurosurgical procedure for the management of hydrocephalus, albeit with many complications. ⋯ The findings of this retrospective study show that the long-term ventriculoperitoneal shunt survival remains low in adult transition patients with pediatric-onset hydrocephalus.
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Tinnitus is predominantly viewed as the consequence of dysfunctional hyperactivity, plastic change, or synchronized oscillations in the central auditory system. An alternative to the current auditory-centric view of auditory phantom perception is the basal ganglia-centric view. Recent electrical stimulation experiments in area LC, a locus of the caudate nucleus positioned at its anterior body, has shown loudness modulation of existing tinnitus percepts. ⋯ Neuromodulation of area LC can trigger temporary gate dysfunction and reversibly release new phantoms for conscious awareness. Restoration of restrictive dorsal striatal gate function to treat problematic phantom percepts may be realized by adopting long-term area LC neuromodulation and choosing optimal stimulation parameters.
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Diffusion tensor (DT) imaging-based fiber tracking is a noninvasive magnetic resonance technique that can delineate the course of white matter fibers. ⋯ DT imaging-based fiber tracking is a reliable and accurate method for mapping the course of subcortical PTs. Fiber tracking and intraoperative MEPs were useful for preserving motor function in patients with gliomas near the PT.
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Outcome of lumbar disc herniation is often based on clinical scores and less frequently on the neurological examination. However, even when clinical outcome measures are favorable, patients may still experience motor or sensory impairment. ⋯ There seems to be no correlation between clinical results and neurological impairment when assessed by the VAS and ODI.