Neurosurgery
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DEVELOPMENT OF FIREARMS in the 16 century produced profound changes in the art of warfare and raised new problems for the physician-surgeons. Old assumptions and wrong interpretations delayed the rational approach to the head injuries inflicted by missiles. Evolution of thought and increased experience over the century ultimately led to a surgical practice that can be regarded as the best possible solution allowed by contemporary knowledge and technology.
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Comparative Study
Polymerase chain reaction for the rapid detection of cerebrospinal fluid shunt or ventriculostomy infections.
Infection after cerebrospinal fluid (CSF) shunts or ventriculostomies is a common complication associated with significant morbidity and mortality. Polymerase chain reaction (PCR) is a powerful molecular technique that allows rapid and precise amplification of bacterial deoxyribonucleic acid (DNA) and has proven a powerful tool in the detection of a wide variety of clinically important infectious diseases. We analyzed specimens of CSF derived from ventriculoperitoneal shunts or external ventricular drains by using both conventional cultures and PCR and report herein our preliminary results. ⋯ These preliminary data suggest that PCR is a highly sensitive, rapid, and potentially promising modality for the detection and treatment of CSF shunt ventriculostomy infection.
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Comparative Study
Concussion in professional football: comparison with boxing head impacts--part 10.
This study addresses impact biomechanics from boxing punches causing translational and rotational head acceleration. Olympic boxers threw four different punches at an instrumented Hybrid III dummy and responses were compared with laboratory-reconstructed NFL concussions. ⋯ Olympic boxers deliver punches with high impact velocity but lower HIC and translational acceleration than in football impacts because of a lower effective punch mass. They cause proportionately more rotational acceleration than in football. Modeling shows that the greatest strain is in the midbrain late in the exposure, after the primary impact acceleration in boxing and football.
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To report the clinical outcomes following treatment of trigeminal neuralgia with linear accelerator-based radiosurgery. ⋯ Linear accelerator-based radiosurgery for medication refractory trigeminal neuralgia provides effective pain relief with a low complication rate.
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Case Reports
Fracture of subthalamic nucleus deep brain stimulation hardware as a result of compulsive manipulation: case report.
Trichotillomania (TTM) is an impulse control disorder characterized by the recurrent pulling of one's hair resulting in noticeable hair loss. There has been no definite association drawn between Parkinson's disease (PD) and TTM, although there is a suggestion that obsessive-compulsive symptomatology may be more prevalent in left-side predominant PD. We believe that it is important to be aware of psychiatric comorbidities in the surgical treatment of PD, as they may significantly impact the postoperative course. ⋯ Before surgery, this patient's TTM was right-sided, but after subthalamic nucleus deep brain stimulation, her wound picking was only left-sided. This case suggests that subthalamic nucleus deep brain stimulation may have a role in unleashing the symptomatology of TTM through an as yet poorly understood mechanism. Furthermore, there is also an implication that the pathophysiology of PD and TTM may be intertwined.