Neurosurgery clinics of North America
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Neurosurg. Clin. N. Am. · Apr 1997
ReviewBrain attack. Acute therapeutic interventions. Free radical scavengers and antioxidants.
Evidence suggesting a role of oxygen radical-induced lipid peroxidation in global and focal ischemic brain damage is reviewed, and the potential for treatment of these conditions with antioxidant compounds is highlighted. This article also presents a basis for appreciating the pharmacologic mechanisms by which oxygen radical damage can be inhibited.
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Neurosurg. Clin. N. Am. · Jan 1997
ReviewAtypical facial pain and other pain syndromes. Differential diagnosis and treatment.
Knowledge of each differential diagnosis of prosopalgia is important to any neurosurgeon who treats facial pain. Pain control is possible with treatment specific to the diagnosis, including those forms of facial pain known to be the most difficult to treat. An outline for the management of atypical facial pain, anesthesia dolorosa, and postherpetic neuralgia is presented with a review of the correlative anatomy for each surgical procedure.
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It has been the goal of this article to provide the reader with a brief background of fMRI, a basic understanding of the techniques of fMRI, and, more importantly, the potential for clinical and experimental studies using fMRI. In contrast to the limited number of installed PET and MEG units, the large installed base of MR imaging scanners (over 1000 installed at least at 1.5 T in the United States) makes fMRI potentially widely available. ⋯ The areas of language lateralization and memory are still preliminary at best. As methods to reduce the effects of head motion (due to both bulk head motion and physiologically induced motion) arise, the reliability of fMRI should improve, allowing for more definitive identification of task activation.
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Neurosurg. Clin. N. Am. · Oct 1996
ReviewJugular bulb oximetry for the monitoring of cerebral blood flow and metabolism.
Jugular bulb oximetry can be used to assess the balance between oxygen supply and demand to the brain, measure metabolic byproducts, and determine cerebral blood flow. It has been useful in guiding the management of patients who are at risk of developing global ischemia. ⋯ Technical considerations such as placement techniques, factors affecting accuracy, limitations of the technique, and proper interpretation of oximetric values are reviewed. Lastly, specific clinical applications are presented.
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Interactive image-guided techniques used in conjunction with three-dimensional images allow accurate planning and performance of a variety of neurosurgical procedures. The authors have used the frameless stereotactic Allegro Viewing Wand System to provide real-time correlation of the operating field and computerized images in over 200 neurosurgical operations carried out for intractable epilepsy. The authors experience shows that the viewing wand system is most helpful as an adjunctive navigational device in the microsurgical treatment of epilepsy.