World Neurosurg
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Case Reports
Functional Activation Patterns of Deep Brain Stimulation of the Anterior Nucleus of the Thalamus.
Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a recently approved therapy for patients with drug-resistant epilepsy. To date, there is a poor understanding of the mechanism of action and lack of in vivo biomarkers. We propose a method for investigating the in vivo stimulation effects using blood-oxygen-level-dependent (BOLD) magnetic resonance imaging (MRI) and present the brain activation pattern associated with ANT DBS. ⋯ Using block-design BOLD MRI, we were able to show widespread activation resulting from ANT DBS. Overlap with multiple areas of both the default mode and limbic networks was shown, suggesting that these nodes may modulate the effect of seizure control with ANT DBS.
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The present study was performed to elucidate the role of nitric oxide (NO) and connexin 40 (Cx40) in the induction of cerebral vasospasm after subarachnoid hemorrhage (SAH) in vivo. ⋯ The NO-cGMP-PKG pathway alleviated cerebral vasospasm via Cx40 upregulation.
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Case Reports
Patient with Epilepsy Caused by the Spontaneous Rupture of an Intracerebral Dermoid Cyst: A Case Report.
This is a rare case of a patient presenting with epileptic seizures and headaches who was diagnosed with spontaneous intracerebral dermoid cyst rupture via radiographic imagery, and rupture was confirmed via a pathology report. ⋯ We discuss the clinical and radiologic features, as well as the treatment of this patient.
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Although arteriovenous malformation (AVM) has been considered to be a congenital vascular malformation, morphologic differences associated with age have been indicated in the literature. ⋯ The present case suggests the possibly that AVM morphology may change with age and is an important when considering the history of AVM.
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Although instrumented stabilization of pediatric atlanto-occipital dislocation (AOD) has been described in the literature, there is little evidence regarding instrumentation techniques in pediatric patients presenting with both AOD and a cervical fracture. We present a case of a 2-year-old male involved in a motor vehicle collision with an unstable C2 fracture and AOD, treated with an occiput-C4 posterior arthrodesis using a rod, crosslink, and cable construct. ⋯ Although there is a breadth of literature investigating instrumentation approaches to pediatric AOD, there is minimal evidence on outcomes of patients presenting with both AOD and cervical fracture. The technique we describe has proven safe and effective for this patient.