World Neurosurg
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Case Reports
Vagal Nerve Stimulator Malfunction with Change in Neck Position: Case Report and Literature Review.
Vagal nerve stimulation is a safe and well-tolerated treatment for drug-resistant epilepsy. Complications and failure of the device can result from lead fracture, device malfunction, disconnection, or battery displacement and can result in a variety of symptoms. We present an interesting case of stimulator malfunction with increased impedance change seen only with a change in head position. ⋯ VNs malfunction can present in atypical ways. Positional maneuvers may help with its timely diagnosis.
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We used functional magnetic resonance imaging to provide a longitudinal description of cortical plasticity caused by electroacupuncture (EA) of sciatic nerve transection and direct anastomosis in rats. ⋯ The alterations in the brain brought about by the long-term therapeutic effect of EA could be described as a synchronized activation pattern in the somatosensory and pain-related areas and a fluctuating pattern in the limbic/paralimbic system.
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In case of carotid artery occlusion, the risk and extent of ischemic cerebral damage are highly dependent on the pathways of collateral flow including the anatomy of the circle of Willis. In this report, cases are presented to illustrate that 4-dimensional computed tomography angiography (4D-CTA) can be considered as a noninvasive alternative to digital subtraction angiography for the evaluation of circle of Willis collateral flow. ⋯ Temporal dynamics of collateral flow in the circle of Willis can be depicted with 4D-CTA in patients with a unilateral carotid artery occlusion.
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The 2013 Physician Payments Sunshine Act mandates that all U.S. drug and device manufacturers disclose payments to physicians. All payments are made available annually in the Open Payments Database (OPD). Our aim was to determine prevalence, magnitude, and nature of these payments to physicians performing neurologic surgery in 2015 and to discuss the role that financial conflicts of interest play in neurosurgery. ⋯ The neurological surgery specialty receives substantial annual payments from industry in the United States. The overall value is driven by a small number of payments of high monetary value. The OPD provides a unique opportunity for increased transparency in industry-physician relationships facilitating disclosure of financial conflicts of interest.
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The kinematic characteristics of Modic changes (MCs) in the lumbar spine have rarely been reported; furthermore, the effect of disc degeneration (DD) on segmental motion has not been considered in analyzing the motion characteristics of MCs. Therefore, this study was designed to evaluate the kinematic characteristics of MCs based on different DD grades. ⋯ MC III indicates the final stable phase of segmental motion. MC I might increase angular motion, and MC II would increase certain translational motions in the segments that were believed to be stable.