Neurosurgery
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Comparative Study
Comparison of long-term outcomes associated with endovascular treatment vs surgical treatment among Medicare beneficiaries with unruptured intracranial aneurysms.
Long-term outcomes associated with endovascular and surgical treatments for unruptured intracranial aneurysms are not well studied to date. ⋯ In elderly patients with unruptured intracranial aneurysms, endovascular treatment was associated with lower rates of acute adverse events and long-term all-cause mortality and new intracranial hemorrhages.
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Comparative Study
Comparison of plan quality and delivery time between volumetric arc therapy (RapidArc) and Gamma Knife radiosurgery for multiple cranial metastases.
Volumetric modulated arc therapy (VMAT) has been shown to be feasible for radiosurgical treatment of multiple cranial lesions with a single isocenter. ⋯ For multiple target stereotactic radiosurgery, 4-arc VMAT produced clinically equivalent conformity, dose falloff, 12 Gy isodose volume, and low isodose spill, and reduced treatment time compared with GK. Because of its similar plan quality and increased delivery efficiency, single-isocenter VMAT radiosurgery may constitute an attractive alternative to multi-isocenter radiosurgery for some patients.
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Roger Goodell was invited by the Neurosurgical Society of America (NSA) to give the keynote speech as the NSA Medalist 2013. As President of the NSA, and Co-Chairs of the National Football league's Head Neck and Spine Committee, we provided the introduction for Goodell. ⋯ Mr Goodell's national leadership in thinking and acting boldly on the subject of traumatic brain injury prevention and treatment was the primary motivation for awarding him the NSA medal. What follows is a transcript of his NSA Medal Lecture to the Neurosurgical Society of America.
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Surgery for frontal lobe epilepsy often has poor results, likely because of incomplete resection of the epileptogenic zone. ⋯ Our findings highlight the importance of differentiating between orbitofrontal plus frontal and orbitofrontal plus temporal polar epilepsy in patients afflicted with seizures involving the orbitofrontal cortex. For identified cases of orbitofrontal plus temporal polar epilepsy, a multilobar resection including the temporal pole may lead to improved postoperative outcomes with minimal morbidity or mortality.
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Individually, immunomodulatory therapy and chondroitinases have demonstrated neuroprotective and potential neuroregenerative effects following spinal cord injury. ⋯ The present data suggest that delivery of an immunomodulatory therapy consisting of clodronate and rolipram, in combination with ChABC, reduces axonal injury and enhances neuroprotection, plasticity, and hindlimb functional recovery after hemisection spinal cord injury in adult rats.