World Neurosurg
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Multicenter Study Clinical Trial
Subthalamic nucleus deep brain stimulation for Parkinson's disease in Hong Kong: A prospective territory-wide 2 year follow-up study.
We assessed the effects of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with Parkinson disease at the 1-year and 2-year follow-up evaluations. Unified Parkinson's Disease Rating Scale (UPDRS) motor score at "off" medication ("on" DBS) and quality-of-life assessments (39-item Parkinson's Disease Questionnaire [PDQ-39]) were conducted. The percentage of awake "on" time and awake "off" time and levodopa requirement were also assessed. ⋯ The effects of STN DBS in patients with Parkinson disease in Hong Kong were satisfactory. The results showed that reduction in UPDRS motor score, awake "off"-time, and daily levodopa dosage were the major drivers of overall improvement in PDQ-39.
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Review Case Reports
Cervical myelopathy caused by bilateral laminar cleft of the axis: A case report and review of the literature.
Cervical myelopathy due to bilateral laminar cleft of the axis is extremely rare, and few cases have been previously reported. However, its treatment is relatively simple. Surgical removal of the anomalous bony structure compromising the spinal canal can sufficiently achieve a good outcome. ⋯ Invaginated bilateral laminar cleft of the axis is a rare cause of cervical myelopathy. The findings in our case should broaden the radiographic differential diagnosis in patients with cervical myelopathy. Surgical removal is an appropriate and simple treatment for this patient, resulting in a satisfactory outcome.
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Review Case Reports
Insular and Sylvian Fissure Dermoid Cyst with Giant Cell Reactivity: A Case Report and Review of the Literature.
Dermoid cysts are rare intracranial tumors that are most commonly found infratentorially and along the midline. Characterized by slow growth and often found incidentally, these lesions can nonetheless have severe complications, notably rupture leading to chemical meningitis. They infrequently present as a supratentorial and lateralized mass. As such, sylvian fissure dermoid cysts are exquisitely rare. We present a rare case of a dermoid cyst with giant cell reactivity suggestive of focal rupture and chronic inflammation. ⋯ The dermoid cyst in our patient was not grossly ruptured, but histopathologic analysis revealed giant cell reactivity, which may indicate focal rupture or chronic inflammation. The relationship between rupture of dermoid cysts and inflammation is not well elucidated. It is not known whether symptoms occur immediately after rupture or as an acute manifestation of a chronic process following rupture. As these lesions are quite rare and rupture is even rarer, more diligence on our part regarding details of histopathology for dermoid cysts is necessary.
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Review Case Reports
Co-existent supra and infratentorial subdural hygromas with hydrocephalus after Chiari decompression surgery: review of literature.
Foramen magnum decompression (FMD) is the standard procedure for Chiari I malformation. Although seemingly a straightforward procedure, recent articles have reported an increase in various complications. We describe a rare complication of coexistent supratentorial and infratentorial subdural hygromas (SDHs) with hydrocephalus noted after FMD and provide a detailed review of the literature on this topic. ⋯ Coexistent supratentorial and infratentorial SDHs with hydrocephalus after Chiari decompression is a very rare occurrence. Treatment needs to be individualized based on the predominant symptomatic lesion, and surgical options need to be judiciously considered. Good prognosis is the rule in most cases.
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From Luessenhop's early clinical experience until the present day, experimental methods have been introduced to make progress in endovascular neurosurgery. ⋯ We must learn how to safely practice endovascular neurosurgery in the presence of uncertainty and verify patient outcomes in real time.