World Neurosurg
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Treatment-related chronic neuropathic pain represents a major and increasing cause of discomfort in cancer survivors. Unfortunately, in approximately 10%-15% of cases, pain is scarcely relieved by opioids and common painkillers. Thus, alternative measures to manage pain have recently been adopted in these patients. ⋯ To the best of our knowledge, this is the first report in literature describing peripheral nerve field stimulation as a treatment option for intractable cancer treatment-related chronic neuropathic pain. Peripheral nerve field stimulation appears to be a safe and effective procedure.
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Patient safety aspects and the residents' role in spine surgery within a structured training program have recently been investigated. The current work deals with residency training safety aspects for cranioplasty (CP), a standard neurosurgical cranial procedure. ⋯ A relatively simple cranial procedure, such as CP, can be safely performed by a supervised neurosurgery resident without increasing complications or compromising patients' outcomes.
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Tuberous sclerosis complex (TSC) has an incidence of 1/6000 in the general population. Overall care may be complex and costly. We examine trends in health care utilization and outcomes of patients with TSC over the last decade. ⋯ Our study identifies aspects of inpatient health care utilization, outcomes, and cost of a large number of patients with TSC. These aspects include related diagnoses and procedures that contribute to longer length of stay, increased hospital cost, and increased in-hospital mortality, which can inform strategies to reduce costs and improve care of patients with TSC.
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This report describes the authors' experience and technique in removing vagus nerve stimulator leads, including coils, and reuse of the same site on the vagus nerve for implantation of new coils. ⋯ Vagus nerve stimulator coils can be removed from the vagus nerve, via monopolar microneedle electrocautery, and the same site reused for immediate reimplantation with relative safety.
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To evaluate the effectiveness of bypass surgery for moyamoya disease, electrocorticography was first evaluated. ⋯ The spectral power of the beta band on electrocorticography was focally suppressed in patients with moyamoya disease, and the suppression was reversible by revascularization surgery. Steno-occlusive ischemic changes in moyamoya disease might cause suppression of neurophysiologic activity, and the present results provide insight into the potential neuromodulatory role of revascularization surgery.