Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Deep brain stimulation (DBS) of the ventral intermediate nucleus of the thalamus (VIM) is a powerful surgical option in the treatment of tremor-predominant Parkinson's disease. However, its therapeutic efficacy depends on the tremor distribution. ⋯ Also, it is generally thought that DBS of the VIM has no significant beneficial effects on other motor symptoms of Parkinson's disease. We report two hemiparkinsonian patients, in whom unilateral VIM DBS combined with posteroventral pallidotomy produced long-lasting suppression of not only hand tremor, but also leg or jaw tremor and other motor symptoms.
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The Glasgow Outcome Scale (GOS) score is widely used to assess outcome after a subarachnoid hemorrhage (SAH). Patients who have recovered fully or with a mild disability (GOS scores 4 and 5) frequently complain about difficulties in conducting their daily activities. The Short Form-36 (SF-36) Health Survey is a questionnaire that assesses outcomes in multiple categories. ⋯ We conclude that patients continue to suffer neuropsychological deficits years after a SAH. The GOS score is a rough outcome measure that primarily focuses on physical functioning. SF-36 is a useful tool to include in the neuropsychological outcome assessment of patients with SAH.
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Case Reports
Venous air emboli from intravenous catheterization: a report of iatrogenic intravascular pneumocephalus.
Pneumocephalus in the absence of a recent intracranial or intrathecal procedure is a significant radiographic finding and may be clinically relevant. Pneumocephalus secondary to intravenous catheterization may be a more common finding than previously expected. ⋯ This unexpected radiographic finding should not necessarily be cause for alarm, and there is no evidence that intravenous pneumocephalus alone is harmful. We present a patient with intravenous pneumocephalus and a review of the literature.
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The importance of preserving the deep cerebral venous outflow has been recognized in microvascular decompression for trigeminal neuralgia; however, few reports have described the details of complications arising from the sacrifice of the superior petrosal vein (SPV). During the procedure in a 77-year-old woman, some tributaries of the SPV complex were sacrificed to achieve microvascular decompression for right trigeminal neuralgia. ⋯ Sacrifice of the SPV may lead to serious, potentially life-threatening complications. Neurosurgeons should pay close attention to the management of the SPV to reduce the risk of venous complications.