Neurosurgery
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Well-documented case reports of the rapid formation and rupture of de novo aneurysms of the posterior circulation are rare. ⋯ We review the pertinent literature and discuss possible reasons for the development and rupture of this second aneurysm.
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We prospectively investigated the predictive value of diffusion tensor tractography for motor functional outcome in a case series of patients with intracerebral hemorrhage. ⋯ Motor functional outcome in patients with intracerebral hemorrhage can be predicted by measuring FA values using diffusion tensor tractography.
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In the selection of a ventriculoperitoneal cerebrospinal fluid shunt, the intra-abdominal pressure (IAP) is traditionally neglected as a result of the idea that its value is close to 0 mmHg. Our aim was to explore the relationship between body mass index (BMI) and IAP with the goal of providing clinically relevant data that could help neurosurgeons to estimate IAP and select the appropriate shunt for patients with hydrocephalus and especially those with normal-pressure hydrocephalus syndrome. ⋯ In our study, we determined that IAP had a strong positive linear relationship with BMI. This correlation was independent of sex. An IAP of 0 mmHg can, therefore, only be assumed for patients with a normal BMI who are recumbent. In obese or overweight patients, neurosurgeons should take IAP into account when selecting both the most adequate differential pressure valve to be implanted and in which distal cavity to place the distal catheter to avoid shunt underdrainage induced by high IAP.
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Diffusion tensor imaging (DTI) allows in vivo delineation of brainstem white matter tracts. The purpose of this study was to determine whether or not abnormalities of DTI metrics and fiber tractography correlate with neurological deficits and clinical status in patients with primary posterior fossa tumors. ⋯ In patients with well-circumscribed primary posterior fossa masses, higher mean diffusivity and lower FA in the brainstem corticospinal tract are associated with contralateral motor deficits; lower transverse eigenvalue may be observed with an unfavorable clinical outcome.
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To determine whether or not administration of brain-derived neurotrophic factor (BDNF) with osmotic pumps at the site of the proximal stump of a peripheral nerve autograft can improve peripheral nerve regeneration. ⋯ BDNF delivered through osmotic pumps was found to have a significant capacity for improving the presence of motoneurons in the ventral spinal horn and, thus, capacity to improve nerve regeneration through nerve autografts. However, in this study, BDNF did not specifically protect against injury to motoneurons, depending on the soma size.