World Neurosurg
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Multicenter Study
Associations of endothelin polymorphisms and aneurysm size at the time of rupture.
Aneurysm size is an important risk factor for aneurysm rupture. The pathophysiologic mechanisms underlying aneurysm growth remain poorly understood. Endothelin signaling is critical for cerebrovascular blood flow regulation. The influence of endothelin single nucleotide polymorphisms (SNPs) on aneurysm size at the time of rupture has not been previously investigated. ⋯ The EDNRA SNP rs5335 was independently associated with aneurysms ≥7 mm in size at the time of rupture. Patients with cerebral aneurysms also carrying the G allele of EDNRA SNP rs5335 may develop larger aneurysms before rupture.
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Microvascular decompression (MVD) of the facial nerve monitored intraoperatively by abnormal muscle response (AMR) activity is a common treatment for hemifacial spasm. AMR frequently persists after MVD, however, for which electromyography (EMG)-guided nerve combing sometimes is recommended. Because no research regarding the success of EMG-guided nerve combing has been published, we compared the effectiveness of nerve combing after MVD with simple MVD in cases including persistent AMR. ⋯ In cases of hemifacial spasm with persistent AMR after MVD, EMG-guided nerve combing significantly improved the success rate of the operation. Although it also significantly increased the incidence of postoperative facial palsy over the short term (up to 1 week), incidences in the long term were not significantly different.
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The medical literature still lacks information about the impact of surgery and adjuvant treatment on the life of patients with meningioma. The clinical outcome, timing of tumor recurrence, and causes of death are often overlooked. This study evaluates these data taking into account tumor localization and histologic grade. ⋯ Histologic grade is the most important factor for long-term survival. Complete resection has to be pursued in GII and GIII meningioma but must be carefully weighed against morbidities in GI meningioma.
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Historical Article
Neurosurgery and Music; The effect of Wolfgang Amadeus Mozart.
The nervous system works like a great orchestra. Specifically, the music of Mozart with its "Mozart effect" is appropriate to use in neurosurgery. We investigated the relationship between Mozart's music and neurosurgery. ⋯ It is clear that we have much to learn from studies about music and brain function that derive from our surgical experiences with patients. The neuronal plasticity of musicians' brains may be different from that of nonmusicians' brains. Musicians with enhanced motor skills have greater capacity for plasticity because of enriched interhemispheric connections. Listening to music and the effect of Mozart in neurosurgical practice, intensive care, or rehabilitation were documented in many studies. As authors, we mean something different: Its effectiveness should be studied. We concluded that in current neurosurgical practice, Mozart has an effect. More research and clinical studies are needed.
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To assess the contribution of low-field intraoperative magnetic resonance (iMRI) to endoscopic pituitary surgery. ⋯ Low-field iMRI is a useful and safe assistance even in advanced surgical techniques such as endoscopy. Its contribution is limited by the intrinsic features of the tumor. Further randomized studies are required to confirm the cost-effectiveness of iMRI in pituitary surgery.