World Neurosurg
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In patients with intractable epilepsy, failure to localize and/or resect the epileptic focus after invasive monitoring is multifactorial. Rarely do these patients return for a second invasive evaluation, and their outcome is not clearly characterized. This study aims to determine the seizure outcome after a second invasive electroencephalographic (EEG) evaluation, and its possible predictors. ⋯ A second invasive evaluation may lead to seizure freedom in one-third of patients. However, this must be weighed against the increased complication rate with reoperation.
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Hardware-related complications of deep brain stimulation (DBS) surgery have been reported with adverse effects in postoperative electrode migration. We report that the addition of microtextured features to the surface of a DBS-like probe can minimize the extent of electrode migration in ex vivo porcine brain. ⋯ These preliminary results show that microtextured strips embedded into cadaveric porcine brain produce an anchoring effect on local tissue during brain shift, suggesting a way to reduce DBS lead migration without additional tissue damage beyond the strip geometry.
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Adequate adrenal response is fundamental for the maintenance of physiological homeostasis in the setting of trauma and severe illness. Patients with neurogenic shock are at risk of severe consequences if adrenal insufficiency (AI) is not rapidly identified and treated. ⋯ Adrenal insufficiency is a poorly recognized complication in patients with acute cervical spinal cord injury and its aggressive treatment is of utmost importance to avoid further neurological injury.