Turk Neurosurg
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To examine the use of prognostic factors such as age, Glasgow Coma Scale (GCS) score, pupil reactivity and computerized tomography (CT) findings for predicting the prognosis of severe traumatic brain injury (TBI) patients in Turkey. ⋯ In our study, GCS score, CT findings and pupil reactivity were prominent as prognostic factors, but a relationship between age and prognosis was not observed.
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To investigate high-intensity zone (HIZ) changes after lumbar posterior dynamic instrumentation. ⋯ Dynamic lumbar stabilization systems are promising. Observations such as Pfirrmann grade improvements and disappearance of HIZs are concordant with improvements in VAS and ODI scores demonstrate that dynamic stabilization systems may provide an environment for regeneration.
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The "trephined" syndrome is a relatively rare complication after a large skull bone defect, consisting of a sunken skin above the bone defect with neurological symptoms such as severe headaches, mental changes, focal deficits, or seizures. Emerging data show improvements in the patients' neurological status after cranioplasty, i.e. the surgical intervention to repair cranial defects. ⋯ His motor and neuropsychological status greatly improved after cranioplasty. Our results confirmed previous reports that cranioplasty may significantly improve neuropsychological and motor function, as evaluated by specific tests, in patients with skull bone defects, and even in patients with DOC.
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Deep brain stimulation (DBS) of the subthalamic nucleus (STN) relieves motor dysfunction in advanced Parkinson's disease (PD). However, STN DBS treated patients can experience unpleasant and debilitating psychiatric side effects such as depression and impulsivity. The neural basis of these psychiatric effects has been linked to a dysfunction of 5-hydroxytryptamine (5-HT, serotonin) neurotransmission. STN DBS inhibited activity of 5-HT cell bodies in the dorsal raphe nucleus (DRN). Another important 5-HT source is located in the median raphe nucleus (MRN), which also contains a population of dopamine neurons. The effects of STN DBS on the MRN are unknown. Here, we test the hypothesis that STN DBS reduces 5-HT and dopaminergic function in the MRN, which may contribute to the psychiatric side effects of STN stimulation. ⋯ These results show that STN DBS inhibits 5-HT and dopamine neurotransmission in the MRN.
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Remote intraparenchymal hemorrhage after clipping of a ruptured aneurysm is rare. The pathogenesis is variable, and the therapeutic strategies remain controversial, because the natural history is unclear. Here we report a woman with subarachnoid hemorrhage (SAH), who had an aneurysm of the anterior communicating artery identified by computed tomography angiography (CTA). ⋯ CT images performed immediately after surgery showed that two intraparenchymal hemorrhages were present contralateral to the site of the operation. After conservative treatment, the patient recovered, but still displayed a movement disorder in the left limb. SAH induced-vasospasm, defective vascular autoregulation, excessive drainage of the cerebrospinal fluid, a change in the intracranial pressure after craniotomy, and brain shift may contribute to the pathogenesis of remote hemorrhage after surgery.