World Neurosurg
-
To determine whether there is a measureable change in neurologic function after cranioplasty. ⋯ A small but significant number of patients appear to improve clinically after cranioplasty. Neurologic susceptibility to a skull defect may be more common than had been appreciated previously.
-
Degeneration of intervertebral disks in the lower lumbar spine is associated with significant structural alterations. Finite element model has been widely used in the study of spinal mechanical behaviors. Our study used this technique to characterize the motional influence to the double-level (L4-5 and L5-S) degeneration. ⋯ Different loading motions in double-level degeneration had differing effects on the ROM. These changes are important to understand the biomechanics of the progression of disk degeneration in the lower lumbar spine. Our results provide insights for the clinical intervention of double-level intervertebral disks.
-
The Role III, Multinational Medical Unit at Kandahar Air Field, Afghanistan, was established to provide combat casualty care in theater for International Security Assistance Forces, Afghanistan National Security Forces, and local nationals during Operation Enduring Freedom-Afghanistan. The authors describe their experience of treating unstable lumbar spine fractures with orthopedic extremity instrumentation sets from January 2007 to January 2008 and November 2010 to May 2011. ⋯ In the combat environment with sparse resources, unstable spine fractures may potentially be treated using instrumentation not specifically designed for spinal implantation. This is an off-label use, and the authors do not recommend the use of these techniques as standard treatment in most medical environments.
-
Preoperative endovascular embolization as a treatment for hypervascular glioblastomas has not been established. We report the case of an extreme hypervascular glioblastoma mimicking an arteriovenous malformation that was successfully treated with preoperative embolization and subsequent removal. ⋯ This is the first reported case of presurgical embolization of a glioblastoma with a high-flow shunt. Embolization of a malignant tumor with a high-flow shunt, in a manner similar to embolization of arteriovenous malformations, is feasible and effective.
-
Deep brain stimulation (DBS) of the anterior cingulate cortex (ACC) is a new treatment for alleviating intractable neuropathic pain. However, it fails to help some patients. The large size of the ACC and the intersubject variability make it difficult to determine the optimal site to position DBS electrodes. The aim of this work was therefore to compare the ACC connectivity of patients with successful versus unsuccessful DBS outcomes to help guide future electrode placement. ⋯ These findings could help improve presurgical planning by optimizing electrode placement, to selectively target the tracts that help to relieve patients' pain and to avoid those leading to unwanted effects.