Current neurology and neuroscience reports
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Curr Neurol Neurosci Rep · Nov 2004
ReviewDiagnosis and management of brain abscess and subdural empyema.
Advances in the diagnosis and treatment of brain abscess and subdural empyema with neuroimaging techniques such as computerized tomography, magnetic resonance imaging, magnetic resonance spectroscopy, the availability of new antimicrobials, and the development of novel surgical techniques have significantly contributed to the decreased morbidity and mortality associated these infections. Determination of point of entry and source of infection is paramount to adequate treatment. A high index of suspicion along with typical clinical presentation of headache, seizures, or focal neurologic signs can lead to early diagnosis so that effective therapy can be instituted as soon as possible. This review discusses etiology and pathology of brain abscess and subdural empyema, neuroimaging techniques useful in the diagnosis, and optimal treatment, including use of antimicrobials and surgical procedures.
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Patients with large hemispheric strokes frequently develop neurologic deterioration secondary to cerebral edema. Regardless of the medical and surgical management of cerebral edema, there is high morbidity and mortality. This article reviews the clinical and radiographic features of large hemispheric strokes and examines the various therapeutic options for management of cerebral edema.
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The surgical treatment of epilepsy is expanding in an exciting and unprecedented way. This review highlights some of the recent advances in neuroimaging that have improved epilepsy surgery. In addition, novel therapies currently being evaluated in clinical trials, including gamma knife radiosurgery, deep brain stimulation, and responsive stimulation, are discussed. Further surgical developments that will be ready for human application in the near future are highlighted.
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Throughout the past decade, there has been a marked increase in surgical therapies, primarily deep brain stimulation (DBS), for the treatment of advanced Parkinson's disease (PD). DBS of the thalamus has been shown to be effective in reducing parkinsonian tremor; however, it is not the treatment of choice for PD given the progression of other symptoms such as rigidity and bradykinesia. ⋯ Complications associated with DBS are related to the experience of the surgical center. Referring physicians and patients should be aware of the number of surgical procedures and complication rates of any prospective surgical center.
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Curr Neurol Neurosci Rep · Mar 2004
Randomized Controlled Trial Multicenter Study Clinical TrialOrally administered sodium oxybate for the treatment of narcolepsy.