Neurological research
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Neurological research · Aug 2017
The utility of FDG-PET in the differential diagnosis of Parkinsonism.
Differential diagnosis of parkinsonian disorders can be difficult on clinical grounds, especially in the early stage. Recent advancements in 18-F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging reveals different patterns of regional glucose metabolism in idiopathic Parkinson's disease (IPD) and atypical parkinsonian syndromes, such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS), which may help differentiating between these conditions. ⋯ FDG-PET may help differentiate between IPD, MSA, PSP and CBS among patients presenting with parkinsonian symptoms, which is important for patient counselling and making early decisions about treatment.
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Neurological research · Jul 2017
Neurological outcome and frequency of overdrainage in normal pressure hydrocephalus directly correlates with implanted ventriculo-peritoneal shunt valve type.
The correlation between neurological outcome and frequency of overdrainage in the management of idiopathic normal pressure hydrocephalus (iNPH) using different ventriculoperitoneal shunt valve types is under investigation. Thus, we retrospectively compared one group of iNPH patients implanted with a programmable differential pressure valve (DPV) with another group treated by implantation of a DPV in combination with a flow-regulated anti-siphon device valve (ASD). ⋯ Our results clearly demonstrate reduction in surgical over-drainage frequency and resulting complications in iNPH patients, with significantly better clinical outcome following insertion of a flow regulated ASD VP shunt compared to a DPV VP shunt, despite both systems comprised a programmable opening pressure mechanism.
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Neurological research · Jul 2017
Anterior retropharyngeal plate screw fixation with bilateral anterior transarticular screws for odontoid fractures ... a new comprehensive technique.
A certain group of odontoid fractures (Anderson and D' Alonzo Type-2) are usually offered surgical treatment. Common surgical option is an anterior odontoid screw. Some of the fractures are not suitable for anterior odontoid screw (anterior oblique, displaced distal fragments and those with atlantoaxial instability) and these are usually offered posterior transarticular screws (Magerl's) or posterior atlantoaxial screw rod/plate fixation (Goel-Harms technique). Posterior surgery involves atlantoaxial fixation with an indirect attempt to reduce and fuse the fracture . Posterior surgery has a risk of injury to the vertebral arteries, hemorrhage from the paravertebral venous plexus and the C2 root ganglion. ⋯ Anterior retropharyangeal approach allows direct fracture fragment realignment under vision with an opportunity to fix in compression mode using the VSP plate, which ensures early fusion across the type-II odontoid fracture. Any associated instability can be treated by additional bilateral anterior transarticular screws. The approach is simple and safe without any risk to the vertebral arteries and biomechanically appealing.
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Neurological research · May 2017
Age-related variations in global spinal alignment and sagittal balance in asymptomatic Japanese adults.
The global spinal sagittal alignment varies widely among healthy individuals as it is affected by not only race, but also aging. We investigated age-related changes in the spinal alignment in asymptomatic Japanese individuals. ⋯ PI; pelvic incidence; SS; sacral slope; PT; pelvic tilt; LL; lumbar lordosis; C7SVA; C7 sagittal vertical axis; SSA; spinosacral angle; TK; thoracic kyphosis; C2-C7SVA; C2-C7 sagittal vertical axis; C2-C7A; C2-C7 Angle; TIA; thoracic inlet angle; NT; neck tilt.
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Neurological research · May 2017
Review Meta AnalysisEfficacy of transsphenoidal surgery in achieving biochemical cure of growth hormone-secreting pituitary adenomas among patients with cavernous sinus invasion: a systematic review and meta-analysis.
Growth hormone-secreting pituitary adenomas in adults can result in severe craniofacial disfigurement and potentially fatal medical complications. Surgical resection leading to remission of the disease is dependent on complete surgical resection of the tumor. Lesions that invade the cavernous sinus may not be safely accessible via an endonasal transsphenoidal surgery (TSS), and the rates of biochemical remission of patients with residual disease vary widely in the literature. We conducted a meta-analysis to examine the prevalence of biochemical remission after TSS among patients with growth hormone-secreting pituitary adenomas with and without cavernous sinus invasion. ⋯ The prevalence of biochemical remission in patients with cavernous sinus invasion was lower than in patients without cavernous sinus invasion after TSS for acromegaly.