Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Hemifacial spasm (HFS) has characteristic and specific electrophysiological features, primarily the lateral spread response (LSR). The aim of this study was to evaluate the correlation between changes in the lateral spread response during microvascular decompression (MVD) and the clinical outcome after MVD. Seventy-two patients with HFS who were treated with MVD were included in this study. ⋯ Out of the 40 patients in whom the LSR disappeared intra-operatively after MVD, five had mild HFS at discharge and four had mild HFS at the 6-moth follow up. The clinical outcome of HFS after MVD does not always correlate with intra-operative EMG abnormality. Therefore, the prognostic value of intra-operative LSR monitoring with respect to long-term results is questionable.
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Non-skull-base intracranial chondrosarcomas are extremely rare. We present a patient with a classic falcine chondrosarcoma and review the radiological features that may aid in a pre-operative diagnosis, as well as the adjuvant treatment options. A 32-year-old woman presented with a 5-year history of progressive weakness in her right leg. ⋯ Intracranial chondrosarcomas that occur above the skull base tend to be of the mesenchymal variety. Classic chondrosarcomas of the falx are rare. The management of these tumours is surgery, with adjuvant radiotherapy for incompletely excised lesions.
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The aim of this study is to present a series of 11 patients with non-discogenic sciatica (NDS), and to review the diagnostic techniques of careful clinical and radiological examination. The cases include lumbar radicular herpes zoster, lumbar nerve root schwannoma, lumbar instability, facet hypertrophy, ankylosing spondylitis, sacroiliitis, sciatic neuritis, piriformis syndrome, intrapelvic mass and coxarthrosis. ⋯ The treatment of choice depended on the primary diagnosis. Detailed physical examinations with special attention paid to the extraspinal causes of sciatica and to pain characteristics are the major components of differential diagnosis of NDS.
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Most trigeminal neuralgia is attributable to vascular compression of the root entry zone of the trigeminal nerve at the pons. Only about 5-10% of trigeminal neuralgia cases are caused by direct compression by ipsilateral cerebellopontine angle tumors. Trigeminal neuralgia caused by contralateral posterior fossa tumors are extremely rare. ⋯ This report describes a case of large meningioma in the left occipital region. The patient's right facial pain subsided gradually after tumor excision. This neuralgia is likely due to a displaced adjacent vessel that developed following brainstem distortion by the tumor.
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Apoptosis is an important element of the secondary processes that occur after spinal cord injury. Calpain and caspases are key proteases in apoptotic cell death. We evaluated the neuroprotective effects of SJA6017 (a calpain inhibitor) and measured functional recovery in a rat spinal cord injury model. ⋯ Tarlov scores revealed that group 3 rats also had ameliorated recovery of limb function. Our results demonstrate that treatment with SJA6017 reduces apoptotic cell death, preserves spinal cord tissue and improves functional outcome. Treating calpain-induced apoptosis with this agent may be a feasible therapeutic strategy for patients with spinal cord injury.