Neurosurgery
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Using the neural stem cell (NSC) clone C17.2, we evaluated the ability of transplanted murine NSCs to attenuate cognitive and neurological motor deficits after traumatic brain injury. ⋯ These data suggest that transplanted NSCs can survive in the traumatically injured brain, differentiate into neurons and/or glia, and attenuate motor dysfunction after traumatic brain injury.
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We analyzed the epidemiology, preoperative management, operative findings, operative treatment, and postoperative results in a group of 99 patients who sustained 100 injuries to the brachial plexus. ⋯ Brachial plexus injury represents a severe, difficult-to-handle traumatic event. The incidence of such injuries and the indications for surgery have increased during recent years. Graft repair and neurotization procedures play an important role in the treatment of patients with such injuries.
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To demonstrate the flexibility of the endoscopic transsphenoidal approach, with respect to nasal and paranasal anatomic features and the extension of different sellar lesions, for customization of the procedure for specific conditions. ⋯ The endoscopic surgical route should be tailored to different sellar lesions, and some modifications of the procedure are recommended in selected cases.
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Case Reports
Rare Actinobacillus infection of the cavernous sinus causing painful ophthalmoplegia: case report.
Actinobacillus actinomycetemcomitans is a gram-negative coccobacillus that is known to cause a wide array of clinical infections in debilitated patients, including periodontal disease, soft tissue abscess, pleural empyema, endocarditis, cerebral abscess, and meningitis. We report a rare A. actinomycetemcomitans cavernous sinus abscess that caused painful ophthalmoplegia in a healthy man. ⋯ We present a rare bacterial abscess of the cavernous sinus causing painful ophthalmoplegia. In patients who present with presumed Tolosa-Hunt syndrome and do not improve with prolonged high-dose corticosteroid therapy, an open biopsy is recommended to exclude a bacterial infection.
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To study the use and advantages of combining the posterior petrosal approach with the anterior petrosal approach to petroclival meningiomas. ⋯ The combined petrosal approach should be considered for patients who have a large petroclival meningioma and serviceable hearing. This approach enhances petroclival exposure and the degree of tumor resection, especially in the area of the petroclival junction, middle clivus, apical petrous bone, posterior cavernous sinus, and Meckel's cave. The combined petrosal approach also allows better visualization of the contralateral side and the ventral brainstem, which facilitates safe dissection of the tumor from the brainstem, the basilar artery, and the perforators. If a patient has an early draining bridging vein to the tentorial sinus (before it reaches the transverse-sigmoid junction) or a prominent sigmoid sinus and jugular bulb, the combined petrosal approach provides significant working space.