MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Neurosurgical Focus' source. Sun, 21 Mar 2010 17:25:06 +0100 http://www.medworm.com/index.php?rid=3329602&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192654%26dopt%3DAbstract Authors: Okonkwo DO, Mummaneni PV PMID: 20192654 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329602 Mon, 01 Mar 2010 00:00:00 +0100 3329602 http://www.medworm.com/index.php?rid=3329600&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192655%26dopt%3DAbstract Authors: Silva FE, Lenke LG Degenerative scoliosis is a prevalent issue among the aging population. Controversy remains over the role of surgical intervention in patients with this disease. The authors discuss a suitable approach to help guide surgical treatment, including decompression, instrumented posterior spinal fusion, anterior spinal fusion, and osteotomy. These treatment options are based on clinical analysis, radiographic analysis of the mechanical stability of the deformity, given pain generators, and necessary sagittal balance. The high potential complication rates appear to be outweighed by the eventual successful clinical outcomes in patients suitable for operative intervention. This approach has had favorable outcomes and could help resolve the controversy. PMID: 2019... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329600 Mon, 01 Mar 2010 00:00:00 +0100 3329600 http://www.medworm.com/index.php?rid=3329591&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192656%26dopt%3DAbstract Conclusions Intraoperative CT-based image guidance for placement of thoracolumbar instrumentation has an accuracy that exceeds reported rates with other image guidance systems, such as virtual fluoroscopy and 3D isocentric C-arm-based stereotactic systems. Furthermore, with the use of intraoperative CT scanning, a postinstrumentation CT scan allows the surgeon to evaluate the accuracy of instrumentation before wound closure and revise as appropriate. PMID: 20192656 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329591 Mon, 01 Mar 2010 00:00:00 +0100 3329591 http://www.medworm.com/index.php?rid=3329585&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192657%26dopt%3DAbstract Conclusions The position of the auricular surface varies in human sacra. These variations are associated with differential load bearing at the sacral joints. Only the high-up sacra demonstrated the presence of accessory articulating facets between L-5 and S-1. The position of the auricular surface can explain or possibly predict low-back pain situations. PMID: 20192657 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329585 Mon, 01 Mar 2010 00:00:00 +0100 3329585 http://www.medworm.com/index.php?rid=3329583&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192658%26dopt%3DAbstract Authors: Matteini LE, Kebaish KM, Volk WR, Bergin PF, Yu WD, O'Brien JR Multiple techniques of pelvic fixation exist. Distal fixation to the pelvis is crucial for spinal deformity surgery. Fixation techniques such as transiliac bars, iliac bolts, and iliosacral screws are commonly used, but these techniques may require separate incisions for placement, leading to potential wound complications and increased dissection. Additionally, the use of transverse connector bars is almost always necessary with these techniques, as their placement is not in line with the S-1 pedicle screw and cephalad instrumentation. The S-2 alar iliac pelvic fixation is a newer technique that has been developed to address some of these issues. It is an in-line technique that can be placed during an open procedur... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329583 Mon, 01 Mar 2010 00:00:00 +0100 3329583 http://www.medworm.com/index.php?rid=3329581&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192659%26dopt%3DAbstract Conclusions Although complications are not insignificant, surgery appears to be an effective option when conservative measures fail to provide relief. PMID: 20192659 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329581 Mon, 01 Mar 2010 00:00:00 +0100 3329581 http://www.medworm.com/index.php?rid=3329580&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192660%26dopt%3DAbstract Conclusions . These results demonstrate that both anterior and posterior decompression (with instrumentation) are effective procedures to improve the neurological outcome of patients with CSM. However, sagittal alignment may be better restored using the anterior approach, but harbors a higher rate of loss of correction. In cases involving a preexisting cervical kyphosis, an anterior or combined approach might be necessary to restore the lordotic cervical alignment. PMID: 20192660 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329580 Mon, 01 Mar 2010 00:00:00 +0100 3329580 http://www.medworm.com/index.php?rid=3329579&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192661%26dopt%3DAbstract Authors: Upadhyaya CD, Berven S, Mumaneni PV Pedicle subtraction osteotomy (PSO) is a powerful technique for correcting a fixed sagittal plane deformity. The authors report the case of a 51-year-old man with a history of multiple prior lumbar operations, flat-back syndrome, thoracic kyphosis, and radiculopathy, who underwent deformity correction surgery with T3-S1 pedicle screw fixation and L-3 PSO. Progressive spondylolisthesis of the PSO segment associated with rod fracture then developed. The patient subsequently underwent anterior and posterior revision surgery. This case is a rare instance of spondylolisthesis following PSO. PMID: 20192661 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329579 Mon, 01 Mar 2010 00:00:00 +0100 3329579 http://www.medworm.com/index.php?rid=3329578&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192662%26dopt%3DAbstract Authors: Bishop FS, Dailey AT, Schmidt MH Charcot spinal disease is a destructive degenerative process involving the vertebrae and surrounding discs, resulting from repetitive microtrauma in patients who have decreased joint protective mechanisms due to loss of deep pain and proprioceptive sensation. The typical presentation of the disease is back pain and progressive spinal instability and deformity. The authors report an unusual case of massive Charcot spinal disease deformity in a patient presenting with increasing abdominal girth and discomfort. PMID: 20192662 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329578 Mon, 01 Mar 2010 00:00:00 +0100 3329578 http://www.medworm.com/index.php?rid=3329577&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192663%26dopt%3DAbstract Authors: Pettigrew DB, Morgan CJ, Anderson RB, Wilsey PA, Kuntz C Understanding regional as well as global spinal alignment is increasingly recognized as important for the spine surgeon. A novel software program for virtual preoperative measurement and surgical manipulation of sagittal spinal alignment was developed to provide a research and educational tool for spine surgeons. This first-generation software program provides tools to measure sagittal spinal alignment from the occiput to the pelvis, and to allow for virtual surgical manipulation of sagittal spinal alignment. The software was developed in conjunction with Clifton Labs, Inc. Photographs and radiographs were imported into the software program, and a 2D virtual spine was constructed from the images. The software then measur... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329577 Mon, 01 Mar 2010 00:00:00 +0100 3329577 http://www.medworm.com/index.php?rid=3329576&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192664%26dopt%3DAbstract Conclusions Surgery for adult scoliosis is associated with improvement in radiographic and clinical outcomes at a minimum 2-year follow-up. Perioperative morbidity includes an approximately 13% risk of pseudarthrosis and a greater than 40% incidence of perioperative adverse events. Incidence of perioperative complications is substantial and must be considered when deciding optimal disease management. Although the quality of published studies in this area has improved, particularly in the last few years, the current review highlights the lack of routine use of standardized outcomes measures and assessment in the adult scoliosis literature. PMID: 20192664 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329576 Mon, 01 Mar 2010 00:00:00 +0100 3329576 http://www.medworm.com/index.php?rid=3329575&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192665%26dopt%3DAbstract Authors: Dorward IG, Lenke LG In addressing adult spinal deformities through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. The Ponte or Smith-Petersen osteotomy provides the least correction, but it can be used at multiple levels with minimal blood loss and a lower operative risk. Pedicle subtraction osteotomies provide nearly 3 times the per-level correction of Ponte/Smith-Petersen osteotomies but carry increased technical demands, longer operative time, and greater blood loss and associated morbidity. Vertebral column resections serve as the most powerful method, providing the most correction in the coronal and sagittal planes, but posing both the greatest technical challenge and the greatest risk to the patient in terms of possible ne... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329575 Mon, 01 Mar 2010 00:00:00 +0100 3329575 http://www.medworm.com/index.php?rid=3329574&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192666%26dopt%3DAbstract Conclusions Minimally invasive surgical correction of adult scoliosis results in mid- to long-term outcomes similar to traditional surgical approaches. Whereas operating times are comparable to those achieved with open approaches, blood loss and morbidity appear to be significantly lower in patients undergoing minimally invasive deformity correction. This approach may be particularly useful in the elderly. PMID: 20192666 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329574 Mon, 01 Mar 2010 00:00:00 +0100 3329574 http://www.medworm.com/index.php?rid=3329563&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192667%26dopt%3DAbstract Conclusions Radiographic outcomes such as the Cobb angle and AVT were significantly improved in patients who underwent a combined transpsoas and posterior approach. Lumbar lordosis was maintained in all patients undergoing the combined approach. The combination of XLIF and TLIF/posterior segmental instrumentation techniques may lead to less blood loss and to radiographic outcomes that are comparable to traditional posterior-only approaches. However, the surgical technique carries significant risks that require further evaluation and proper informed consent. PMID: 20192667 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329563 Mon, 01 Mar 2010 00:00:00 +0100 3329563 http://www.medworm.com/index.php?rid=3329552&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192668%26dopt%3DAbstract Conclusions Degenerative scoliosis of the adult spine is secondary to asymmetrical degeneration of the discs. Surgical decompression and correction of the deformity can be performed from an anterior, posterior, or combined approach. These procedures are often associated with long operative times and a high incidence of complications. The authors' experience with the minimally invasive, lateral retroperitoneal transpsoas approach for placement of a large interbody graft for anterior column support, restoration of disc height, arthrodesis, and realignment is a feasible alternative to these procedures. PMID: 20192668 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329552 Mon, 01 Mar 2010 00:00:00 +0100 3329552 http://www.medworm.com/index.php?rid=3329551&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192720%26dopt%3DAbstract Authors: Heary RF, Karimi RJ The authors describe a surgical technique for the correction of symptomatic degenerative lumbar scoliosis. Using a single, unilateral, interbody cage placed on the concave side of the coronal deformity, combined with a dorsal decompression and instrumented posterolateral fusion, this technique has resulted in excellent curve correction, fusion results, and clinical outcomes in a series of 4 patients. Each of these patients presented with intractable, axial low-back pain and symptomatic unilateral nerve root compression on the concave side of a lumbar scoliotic deformity. The management is described in detail. PMID: 20192720 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329551 Mon, 01 Mar 2010 00:00:00 +0100 3329551 http://www.medworm.com/index.php?rid=3329550&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20192721%26dopt%3DAbstract Conclusions The minimally invasive surgical treatment of adult deformities is a promising method for reducing surgical morbidity. Numerous challenges exist, as the surgical technique does not yet allow for all correction maneuvers used in open surgery. However, as the techniques are advanced, the applicability of minimally invasive surgery for this population will likely be expanded and will afford the opportunity for reduced complications. PMID: 20192721 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329550 Mon, 01 Mar 2010 00:00:00 +0100 3329550 http://www.medworm.com/index.php?rid=3329549&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20196652%26dopt%3DAbstract Conclusions Cases involving PD and camptocormia have a high rate of complications when spinal surgery is performed. The authors prefer to offer spinal surgery only to patients with coexisting spinal stenosis causing radiculopathy or myelopathy. Patients with PD and camptocormia without spinal stenosis may be considered for DBS, but the results are mixed. PMID: 20196652 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3329549 Mon, 01 Mar 2010 00:00:00 +0100 3329549 http://www.medworm.com/index.php?rid=3237654&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20121436%26dopt%3DAbstract Authors: Sanai N, Berger MS Although a primary tenet of neurosurgical oncology is that survival can improve with greater tumor resection, this principle must be tempered by the potential for functional loss following a radical removal. Preoperative planning with functional and physiological imaging paradigms, combined with intraoperative strategies such as cortical and subcortical stimulation mapping, can effectively reduce the risks associated with operating in eloquent territory. In addition to identifying critical motor pathways, these techniques can be adapted to identify language function reliably. The authors review the technical nuances of intraoperative mapping for low- and high-grade gliomas, demonstrating their efficacy in optimizing resection even in patients with negative m... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3237654 Mon, 01 Feb 2010 00:00:00 +0100 3237654 http://www.medworm.com/index.php?rid=3237653&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20121437%26dopt%3DAbstract Authors: Ribas GC The aim of this study was to describe in detail the microanatomy of the cerebral sulci and gyri, clarifying the nomenclature for microneurosurgical purposes. An extensive review of the literature regarding the historical, evolutionary, embryological, and anatomical aspects pertinent to human cerebral sulci and gyri was conducted, with a special focus on microneuroanatomy issues in the field of neurosurgery. An intimate knowledge of the cerebral sulci and gyri is needed to understand neuroimaging studies, as well as to plan and execute current microneurosurgical procedures. PMID: 20121437 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3237653 Mon, 01 Feb 2010 00:00:00 +0100 3237653 http://www.medworm.com/index.php?rid=3237652&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20121438%26dopt%3DAbstract Authors: Pouratian N, Bookheimer SY The adjacency of intracranial pathology to canonical regions of eloquence has long been considered a significant source of potential morbidity in the neurosurgical care of patients. Yet, several reports exist of patients who undergo resection of gliomas or other intracranial pathology in eloquent regions without adverse effects. This raises the question of whether anatomical and intracranial location can or should be used as a means of estimating eloquence. In this review, the authors systematically evaluate the factors that are known to affect anatomical-functional relationships, including anatomical, functional, pathology-related, and modality-specific sources of variability. This review highlights the unpredictability of functional eloquence based... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3237652 Mon, 01 Feb 2010 00:00:00 +0100 3237652 http://www.medworm.com/index.php?rid=3237651&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20121439%26dopt%3DAbstract Authors: Rutten GJ, Ramsey NF New functional neuroimaging techniques are changing our understanding of the human brain, and there is now convincing evidence to move away from the classic and clinical static concepts of functional topography. In a modern neurocognitive view, functions are thought to be represented in dynamic large-scale networks. The authors review the current (limited) role of functional MR imaging in brain surgery and the possibilities of new functional MR imaging techniques for research and neurosurgical practice. A critique of current clinical gold standard techniques (electrocortical stimulation and the Wada test) is given. PMID: 20121439 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3237651 Mon, 01 Feb 2010 00:00:00 +0100 3237651 http://www.medworm.com/index.php?rid=3237650&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20121440%26dopt%3DAbstract Conclusions The integration of anatomical and functional studies allows a safe functional resection of the brain tumors located in eloquent areas. Multimodal navigation allows integration and correlation among preoperative and intraoperative anatomical and functional data. Cortical motor functional areas are anatomically and functionally located preoperatively thanks to MR and fMR imaging and subcortical motor pathways with DT imaging and tractography. Intraoperative confirmation is done with CS and N20 inversion wave for cortical structures and with sCS for subcortical pathways. With this protocol the authors achieved a good volumetric resection in cortical and subcortical tumors located in eloquent motor areas, with an increase in the incidence of neurological deficits in the immediate p... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3237650 Mon, 01 Feb 2010 00:00:00 +0100 3237650 http://www.medworm.com/index.php?rid=3237649&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20121441%26dopt%3DAbstract Authors: Bello L, Castellano A, Fava E, Casaceli G, Riva M, Scotti G, Gaini SM, Falini A Resection of lesions involving motor or language areas or pathways requires the intraoperative identification of functional cortical and subcortical sites for effectively and safe guidance. Diffusion tensor (DT) imaging and fiber tractography are MR imaging techniques based on the concept of anisotropic water diffusion in myelinated fibers, which enable 3D reconstruction and visualization of white matter tracts and provide information about the relationship of these tracts to the tumor mass. The authors routinely used DT imaging fiber tractography to reconstruct various tracts involved in the motor and/or language system in a large series of patients with lesions involving the motor and/or language... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3237649 Mon, 01 Feb 2010 00:00:00 +0100 3237649 http://www.medworm.com/index.php?rid=3237648&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20121442%26dopt%3DAbstract Authors: Szelényi A, Bello L, Duffau H, Fava E, Feigl GC, Galanda M, Neuloh G, Signorelli F, Sala F There is increasing evidence that the extent of tumor removal in low-grade glioma surgery is related to patient survival time. Thus, the goal of resecting the largest amount of tumor possible without leading to permanent neurological sequelae is a challenge for the neurosurgeon. Electrical stimulation of the brain to detect cortical and axonal areas involved in motor, language, and cognitive function and located within the tumor or along its boundaries has become an essential tool in combination with awake craniotomy. Based on a literature review, discussions within the European Low-Grade Glioma Group, and illustrative clinical experience, the authors of this paper provide an overvi... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3237648 Mon, 01 Feb 2010 00:00:00 +0100 3237648 http://www.medworm.com/index.php?rid=3237647&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20121443%26dopt%3DAbstract Conclusions This no-margin technique, based on the subpial dissection, and the repetition of both cortical and subcortical stimulation to preserve eloquent cortex as well as the white matter tracts (U-fibers, projection pathways, and long-distance connectivity) allow optimization of the extent of resection while preserving the quality of life (despite transitory impairment) thanks to mechanisms of brain plasticity. PMID: 20121443 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3237647 Mon, 01 Feb 2010 00:00:00 +0100 3237647 http://www.medworm.com/index.php?rid=3237646&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20121444%26dopt%3DAbstract Authors: Isolan GR, Bianchin MM, Bragatti JA, Torres C, Schwartsmann G Hallucinations can be auditory, visual, tactile, gustatory, or olfactory, and can be caused by psychiatric (such as schizophrenia and depression), neurological (such as cerebrovascular accidents, neoplasia, and infection), or endocrine and metabolic disorders. Musical hallucinations related to neurological disorders are rare. The authors present a case of a patient with a right insular glioma who developed transient musical hallucinations after microsurgical resection of the tumor. PMID: 20121444 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3237646 Mon, 01 Feb 2010 00:00:00 +0100 3237646 http://www.medworm.com/index.php?rid=3237645&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20121445%26dopt%3DAbstract Authors: Duffau H PMID: 20121445 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3237645 Mon, 01 Feb 2010 00:00:00 +0100 3237645 http://www.medworm.com/index.php?rid=3137733&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043712%26dopt%3DAbstract Authors: Niazi TN, Cannon-Albright LA, Couldwell WT Understanding the genetic alterations that contribute to the development of different disease states is key to the ability to screen and treat patients afflicted with these diseases and may someday enable us to prevent their development. The high degree of morbidity and mortality associated with neurosurgical diseases makes this understanding particularly important. Mechanisms for early diagnosis, followed by appropriate treatment in these patients, could significantly alter the morbidity and mortality rates in patients with neurosurgical diseases. The Utah Population Database (UPDB) is a unique resource that allows population-based analysis of the familial nature of diseases with the identification of high-risk pedigrees and predispo... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137733 Fri, 01 Jan 2010 00:00:00 +0100 3137733 http://www.medworm.com/index.php?rid=3137732&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043713%26dopt%3DAbstract Authors: Berger MS, Couldwell WT, Rutka JT, Selden NR PMID: 20043713 [PubMed - as supplied by publisher] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137732 Fri, 01 Jan 2010 00:00:00 +0100 3137732 http://www.medworm.com/index.php?rid=3137731&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043714%26dopt%3DAbstract Authors: King MD, Laird MD, Ramesh SS, Youssef P, Shakir B, Vender JR, Alleyne CH, Dhandapani KM Subarachnoid hemorrhage (SAH) is a devastating neurological injury associated with significant patient morbidity and death. Since the first demonstration of cerebral vasospasm nearly 60 years ago, the preponderance of research has focused on strategies to limit arterial narrowing and delayed cerebral ischemia following SAH. However, recent clinical and preclinical data indicate a functional dissociation between cerebral vasospasm and neurological outcome, signaling the need for a paradigm shift in the study of brain injury following SAH. Early brain injury may contribute to poor outcome and early death following SAH. However, elucidation of the complex cellular mechanisms underlying early b... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137731 Fri, 01 Jan 2010 00:00:00 +0100 3137731 http://www.medworm.com/index.php?rid=3137730&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043715%26dopt%3DAbstract Conclusions These results suggest that the mutant eNOS -786C allele is a significant risk factor in the origin of respiratory and IVH diseases, probably mediating an insufficient supply of endogenous NO in premature infants. PMID: 20043715 [PubMed - as supplied by publisher] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137730 Fri, 01 Jan 2010 00:00:00 +0100 3137730 http://www.medworm.com/index.php?rid=3137729&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043716%26dopt%3DAbstract Conclusions . These data indicate that meningioma tissue can be characterized by metabolic parameters that are not typically identified by histopathological analysis alone. Creatine, glycine, and alanine may be used as markers of meningioma grade, recurrence, and the likelihood of rapid recurrence. These data validate a previous study of a separate group of Grade I meningiomas. PMID: 20043716 [PubMed - as supplied by publisher] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137729 Fri, 01 Jan 2010 00:00:00 +0100 3137729 http://www.medworm.com/index.php?rid=3137728&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043717%26dopt%3DAbstract Authors: Cowperthwaite MC, Mohanty D, Burnett MG As their power and utility increase, genome-wide association (GWA) studies are poised to become an important element of the neurosurgeon's toolkit for diagnosing and treating disease. In this paper, the authors review recent findings and discuss issues associated with gathering and analyzing GWA data for the study of neurological diseases and disorders, including those of neurosurgical importance. Their goal is to provide neurosurgeons and other clinicians with a better understanding of the practical and theoretical issues associated with this line of research. A modern GWA study involves testing hundreds of thousands of genetic markers across an entire genome, often in thousands of individuals, for any significant association with a par... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137728 Fri, 01 Jan 2010 00:00:00 +0100 3137728 http://www.medworm.com/index.php?rid=3137727&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043718%26dopt%3DAbstract Authors: Turner JD, Williamson R, Almefty KK, Nakaji P, Porter R, Tse V, Kalani MY MicroRNAs (miRNAs) are now recognized as the primary RNAs involved in the purposeful silencing of the cell's own message. In addition to the established role of miRNAs as developmental regulators of normal cellular function, they have recently been shown to be important players in pathological states such as cancer. The authors review the literature on the role of miRNAs in the formation and propagation of gliomas and medulloblastomas, highlighting the potential of these molecules and their inhibitors as therapeutics. PMID: 20043718 [PubMed - as supplied by publisher] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137727 Fri, 01 Jan 2010 00:00:00 +0100 3137727 http://www.medworm.com/index.php?rid=3137726&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043719%26dopt%3DAbstract In this study, we highlight several genome-wide siRNA screens and implement these experimental concepts in the T98G GBM cell line to uncover the genes and pathways that regulate GBM cell death and survival. These studies will ultimately influence the development of a new avenue of neurosurgical therapy by placing the drug discovery process in the context of the entire biological system. PMID: 20043719 [PubMed - as supplied by publisher] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137726 Fri, 01 Jan 2010 00:00:00 +0100 3137726 http://www.medworm.com/index.php?rid=3137725&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043720%26dopt%3DAbstract Authors: Kahle KT, Kozono D, Ng K, Hsieh G, Zinn PO, Nitta M, Chen CC Our understanding of glioblastoma multiforme (GBM), the most common form of primary brain cancer, has been significantly advanced by recent efforts to characterize the cancer genome using unbiased high-throughput sequencing analyses. While these studies have documented hundreds of mutations, gene copy alterations, and chromosomal abnormalities, only a subset of these alterations are likely to impact tumor initiation or maintenance. Furthermore, genes that are not altered at the genomic level may play essential roles in tumor initiation and maintenance. Identification of these genes is critical for therapeutic development and investigative methodologies that afford insight into biological function. This requirement ha... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137725 Fri, 01 Jan 2010 00:00:00 +0100 3137725 http://www.medworm.com/index.php?rid=3137724&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043721%26dopt%3DAbstract Authors: Northcott PA, Rutka JT, Taylor MD Advances in the field of genomics have recently enabled the unprecedented characterization of the cancer genome, providing novel insight into the molecular mechanisms underlying malignancies in humans. The application of high-resolution microarray platforms to the study of medulloblastoma has revealed new oncogenes and tumor suppressors and has implicated changes in DNA copy number, gene expression, and methylation state in its etiology. Additionally, the integration of medulloblastoma genomics with patient clinical data has confirmed molecular markers of prognostic significance and highlighted the potential utility of molecular disease stratification. The advent of next-generation sequencing technologies promises to greatly transform our unde... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137724 Fri, 01 Jan 2010 00:00:00 +0100 3137724 http://www.medworm.com/index.php?rid=3137723&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043722%26dopt%3DAbstract Authors: Xiromerisiou G, Dardiotis E, Tsimourtou V, Kountra PM, Paterakis KN, Kapsalaki EZ, Fountas KN, Hadjigeorgiou GM Over the past few years, considerable progress has been made in understanding the molecular mechanisms of Parkinson disease (PD). Mutations in certain genes are found to cause monogenic forms of the disorder, with autosomal dominant or autosomal recessive inheritance. These genes include alpha-synuclein, parkin, PINK1, DJ-1, LRRK2, and ATP13A2. The monogenic variants are important tools in identifying cellular pathways that shed light on the pathogenesis of this disease. Certain common genetic variants are also likely to modulate the risk of PD. International collaborative studies and meta-analyses have identified common variants as genetic susceptibility risk/protec... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137723 Fri, 01 Jan 2010 00:00:00 +0100 3137723 http://www.medworm.com/index.php?rid=3137722&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043723%26dopt%3DAbstract Authors: Gottfried ON, Viskochil DH, Couldwell WT Neurofibromatosis Type 1 (NF1) is a common autosomal dominant disease characterized by complex and multicellular neurofibroma tumors, and less frequently by malignant peripheral nerve sheath tumors (MPNSTs) and optic nerve gliomas. Significant advances have been made in elucidating the cellular, genetic, and molecular biology involved in tumor formation in NF1. Neurofibromatosis Type 1 is caused by germline mutations of the NF1 tumor suppressor gene, which generally result in decreased intracellular neurofibromin protein levels, leading to increased cascade Ras signaling to its downstream effectors. Multiple key pathways are involved with the development of tumors in NF1, including Ras/mitogen-activated protein kinase (MAPK) and Akt/mam... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137722 Fri, 01 Jan 2010 00:00:00 +0100 3137722 http://www.medworm.com/index.php?rid=3137721&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20043724%26dopt%3DAbstract Authors: Dardiotis E, Fountas KN, Dardioti M, Xiromerisiou G, Kapsalaki E, Tasiou A, Hadjigeorgiou GM Traumatic brain injury (TBI) constitutes a major cause of mortality and disability worldwide, especially among young individuals. It is estimated that despite all the recent advances in the management of TBI, approximately half of the patients suffering head injuries still have unfavorable outcomes, which represents a substantial health care, social, and economic burden to societies. Considerable variability exists in the clinical outcome after TBI, which is only partially explained by known factors. Accumulating evidence has implicated various genetic elements in the pathophysiology of brain trauma. The extent of brain injury after TBI seems to be modulated to some degree by genetic v... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3137721 Fri, 01 Jan 2010 00:00:00 +0100 3137721 http://www.medworm.com/index.php?rid=3057440&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19951052%26dopt%3DAbstract Authors: Sheehan J, Pouratian N PMID: 19951052 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3057440 Tue, 01 Dec 2009 00:00:00 +0100 3057440 http://www.medworm.com/index.php?rid=3057439&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19951053%26dopt%3DAbstract CONCLUSIONS: Despite the fact that this was a small series of patients with IDIM metastasis who had limited treatment options, SRS appears to be an effective and safe method of treating patients with these lesions. PMID: 19951053 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3057439 Tue, 01 Dec 2009 00:00:00 +0100 3057439 http://www.medworm.com/index.php?rid=3057438&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19951054%26dopt%3DAbstract This article focuses on the emerging evidence for the use of stereotactic body radiotherapy for treatment of HNC as a boost after conventional external-beam radiotherapy, and also as reirradiation in recurrent or second primary HNC. PMID: 19951054 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3057438 Tue, 01 Dec 2009 00:00:00 +0100 3057438 http://www.medworm.com/index.php?rid=3057437&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19951055%26dopt%3DAbstract Authors: Yeung AH, Sughrue ME, Kane AJ, Tihan T, Cheung SW, Parsa AT Vestibular schwannomas (VS) are benign tumors arising from the Schwann cells of cranial nerve VIII. Historically the prevailing therapy for patients with VS has been microsurgical resection. More recently, stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy have gained acceptance as effective alternatives. Although the side effect profile and rates of tumor control appear to be favorable for SRS, there is a subset of radioresistant tumors that continue to progress despite properly administered radiation treatment. In this review, the authors summarize what is known about the mechanism of radioresistance in VS at the clinical and molecular level. An improved understanding of the radiobiological b... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3057437 Tue, 01 Dec 2009 00:00:00 +0100 3057437 http://www.medworm.com/index.php?rid=3057436&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19951056%26dopt%3DAbstract CONCLUSIONS: The results of the study show that the probability of preserving functional hearing in patients undergoing GKS treatment for unilateral VSs is very high. Patients with GR Class I, age younger than 54 years, with presenting symptoms other than hearing loss, and a Koos Stage T1 tumor have better prognosis. The prescribed dose of 13 Gy appears to represent an excellent compromise between controlling the disease and preserving auditory function. PMID: 19951056 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3057436 Tue, 01 Dec 2009 00:00:00 +0100 3057436 http://www.medworm.com/index.php?rid=3057435&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19951057%26dopt%3DAbstract CONCLUSIONS: The results of our review of the literature provide a systematic summary of the published rates of nonaudiofacial morbidity following radiosurgery for vestibular schwannoma. PMID: 19951057 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3057435 Tue, 01 Dec 2009 00:00:00 +0100 3057435 http://www.medworm.com/index.php?rid=3057434&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19951058%26dopt%3DAbstract Authors: Guss ZD, Batra S, Li G, Chang SD, Parsa AT, Rigamonti D, Kleinberg L, Lim M In this article the authors review the literature for recent studies of radiosurgical treatment for glomus jugulare. These studies demonstrate that radiosurgery results in similar glomus jugulare tumor control and a superior morbidity profile compared with surgical treatment. In addition, patients treated with radiosurgery usually remain stable clinically or improve. Given the indolent nature of these tumors, however, more follow-up is required to ensure that the immediate benefits are lasting. These preliminary reports demonstrate that the use of radiosurgery as a primary treatment for glomus jugulare should be extended to encompass more of the patients who are currently assigned to microsurgical trea... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3057434 Tue, 01 Dec 2009 00:00:00 +0100 3057434 http://www.medworm.com/index.php?rid=3057433&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19951059%26dopt%3DAbstract CONCLUSIONS: Image-guided radiosurgical treatment of brain metastases resulted in high rates of tumor control comparable to control rates reported for frame-based methods. High control rates were seen for small lesions in which spatial precision in dose delivery is critical. These data suggests that in regard to lesion control, IGRS using Novalis with ExacTrac is equivalent to frame-based radiosurgery methods. PMID: 19951059 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3057433 Tue, 01 Dec 2009 00:00:00 +0100 3057433 http://www.medworm.com/index.php?rid=3057432&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19951060%26dopt%3DAbstract CONCLUSIONS: Adjuvant SRS to the metastatic intracranial operative bed results in a local recurrence rate equivalent to adjuvant WBRT. In combination with SRS for unresected lesions and routine imaging surveillance, this approach achieves robust overall survival (median 15 months) while sparing 70% of the patients WBRT and its potential acute and chronic toxicity. PMID: 19951060 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3057432 Tue, 01 Dec 2009 00:00:00 +0100 3057432 http://www.medworm.com/index.php?rid=3057431&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19951061%26dopt%3DAbstract Authors: Romanelli P, Conti A, Pontoriero A, Ricciardi GK, Tomasello F, De Renzis C, Innocenzi G, Esposito V, Cantore G Glioblastoma multiforme (GBM) is a devastating malignant brain tumor characterized by resistance to available therapeutic approaches and relentless malignant progression that includes widespread intracranial invasion, destruction of normal brain tissue, progressive disability, and death. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) are increasingly used in patients with recurrent GBM to complement traditional treatments such as resection, conventional external beam radiotherapy, and chemotherapy. Both SRS and fSRT are powerful noninvasive therapeutic modalities well suited to treat focal neoplastic lesions through the delivery of p... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3057431 Tue, 01 Dec 2009 00:00:00 +0100 3057431 http://www.medworm.com/index.php?rid=3057430&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19951062%26dopt%3DAbstract CONCLUSIONS This treatment paradigm for pathological fractures of percutaneous transpedicular corpectomy combined with cement augmentation followed by radiosurgery was found to be safe and clinically effective. This technique combines minimally invasive procedures that avoid the morbidity associated with open surgery while providing spinal canal decompression and immediate fracture stabilization, and then administering a single-fraction tumoricidal radiation dose. PMID: 19951062 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=3057430 Tue, 01 Dec 2009 00:00:00 +0100 3057430 http://www.medworm.com/index.php?rid=2962145&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19883208%26dopt%3DAbstract CONCLUSIONS: Effective treatments exist for the management of CVST, and overall outcomes are more favorable than those for arterial stroke. Further research is necessary to determine the role of individual therapies; however, the rarity of the condition poses a significant limitation. PMID: 19883208 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2962145 Sun, 01 Nov 2009 00:00:00 +0100 2962145 http://www.medworm.com/index.php?rid=2955041&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877787%26dopt%3DAbstract Authors: Nakase H Brain ischemia by arterial occlusion has been a focus of attention for decades, and cerebral venous disorders have been an underestimated condition of potentially good outcome if diagnosed and treated promptly. Recently, there has been considerable interest in cerebral injury following cerebral venous circulation disorders because diagnosis has improved as our understanding of the diseases and modern imaging technologies have advanced. PMID: 19877787 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955041 Sun, 01 Nov 2009 00:00:00 +0100 2955041 http://www.medworm.com/index.php?rid=2955040&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877788%26dopt%3DAbstract Conclusions The authors confirmed that patients with isolated V2 TN were more likely to be female, tended toward an atypical pain classification with venous pathology at surgery, and fared just as well as those presenting with typical pain. PMID: 19877788 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955040 Sun, 01 Nov 2009 00:00:00 +0100 2955040 http://www.medworm.com/index.php?rid=2955039&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877789%26dopt%3DAbstract Authors: Conti A, Pontoriero A, Salamone I, Siragusa C, Midili F, La Torre D, Calisto A, Granata F, Romanelli P, De Renzis C, Tomasello F Symptomatic edema is a potential complication of meningioma radiosurgery. Parasagittal meningiomas are at a particular risk for symptomatic edema, suggesting a role for a venous occlusive complication. The authors sought to develop a strategy to optimize CyberKnife stereotactic radiosurgical treatment parameters to reduce the irradiation of the peritumoral venous system. Multislice CT venography with 3D reconstructions was performed and coregistered with thin-section, contrast-enhanced, volumetric MR images. The tumor and critical volumes were contoured on the MR images. Venous anatomical details obtained from the CT venographic study were then expor... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955039 Sun, 01 Nov 2009 00:00:00 +0100 2955039 http://www.medworm.com/index.php?rid=2955038&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877790%26dopt%3DAbstract Authors: Moftakhar P, Danielpour M, Maya M, Alexander MJ Vein of Galen malformations are rare congenital intracranial vascular malformations. Based on reports in the literature, spontaneous thrombosis or regression of these lesions is rare. Patients have variable outcomes from an asymptomatic course to death. The reasons behind spontaneous thrombosis are not entirely understood. Here the authors present a case of an infant diagnosed with a vein of Galen malformation in utero that subsequently went on to thrombose or regress. A review of the published cases on this phenomenon and the potential causality are discussed. PMID: 19877790 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955038 Sun, 01 Nov 2009 00:00:00 +0100 2955038 http://www.medworm.com/index.php?rid=2955037&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877791%26dopt%3DAbstract Authors: Rangel-Castilla L, Krishna C, Klucznik R, Diaz O Sinus pericranii (SP) is an uncommon and usually asymptomatic communication between intra- and extracranial venous drainage pathways in which blood flow can circulate bidirectionally through abnormal dilated veins through a skull defect. Diagnosis and evaluation of the venous drainage pattern is important if treatment is contemplated. Cerebral angiography with the use of Dyna CT can be helpful in the diagnosis of SP and its relationship with the skull defect. The authors report what is, to the best of their knowledge, the first case of SP treated by means of endovascular embolization with Onyx. PMID: 19877791 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955037 Sun, 01 Nov 2009 00:00:00 +0100 2955037 http://www.medworm.com/index.php?rid=2955036&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877792%26dopt%3DAbstract Authors: Arac A, Lee M, Steinberg GK, Marcellus M, Marks MP Multiple pathophysiological mechanisms have been proposed for the increased intracranial pressure observed in idiopathic intracranial hypertension (IIH). The condition is well characterized, with intractable headaches, visual obscurations, and papilledema as dominant features, mainly affecting obese women. With the advent of MR venography and increased use of cerebral angiography, there has been recent emphasis on the significant number of patients with IIH found to have associated nonthrombotic dural venous sinus stenosis. This has led to a renewed interest in endovascular stenting as a treatment for IIH. However, the assumption that venous stenosis leads to a high pressure gradient that decreases CSF resorption through arach... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955036 Sun, 01 Nov 2009 00:00:00 +0100 2955036 http://www.medworm.com/index.php?rid=2955035&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877793%26dopt%3DAbstract Conclusions The pterional, orbitozygomatic, and supraorbital approaches place the FDV and ATDV at risk. The major anterior diploic system connects the SSS with the sphenoparietal sinus. The posterior diploic system connects the SSS with the transverse and sigmoid sinuses. PMID: 19877793 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955035 Sun, 01 Nov 2009 00:00:00 +0100 2955035 http://www.medworm.com/index.php?rid=2955034&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877794%26dopt%3DAbstract Authors: Filippidis A, Kapsalaki E, Patramani G, Fountas KN Cerebral venous sinus thrombosis (CVST) is a rare clinicopathological entity. The incidence of CVST in children and neonates has been reported to be as high as 7 cases per million people, whereas in adults the incidence is 3-4 cases per million. The predisposing factors to this condition are mainly genetic and acquired prothrombotic states and infection. The clinical picture of CVST is nonspecific, highly variable, and can mimic several other clinical conditions. Diagnosis of CVST is established with the implementation of neuroimaging studies, especially MR imaging and venography. Identification and elimination of the underlying cause, anticoagulation, proper management of intracranial hypertension, and anticonvulsant prophyla... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955034 Sun, 01 Nov 2009 00:00:00 +0100 2955034 http://www.medworm.com/index.php?rid=2955033&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877795%26dopt%3DAbstract Authors: Bentley JN, Figueroa RE, Vender JR Cerebral venous thrombosis is an uncommon cause of stroke but remains a challenge for physicians faced with this diagnosis largely due to the variability in presentation. Anticoagulation, typically with intravenous heparin, remains the mainstay of treatment for stable patients and is sufficient in the majority of cases. However, a significant mortality rate exists for cerebral venous thrombosis due to patients who deteriorate or do not adequately respond to initial treatments. It is in these patients that more aggressive interventions must be undertaken. The neurosurgeon is often called on, either acutely for initial evaluation of the stroke or venous hemorrhage or after the failure of initial therapy for clot evacuation, hemicraniectomy, or ... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955033 Sun, 01 Nov 2009 00:00:00 +0100 2955033 http://www.medworm.com/index.php?rid=2955032&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877796%26dopt%3DAbstract Conclusions Cerebral venous sinus thrombosis secondary to oral contraception in young women, including lesions in critical and deep regions, can be treated medically with acceptable morbidity. In spite of this, a subgroup of patients needed basic neurosurgical management of the lesions, including surgical measures for controlling raised ICP. PMID: 19877796 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955032 Sun, 01 Nov 2009 00:00:00 +0100 2955032 http://www.medworm.com/index.php?rid=2955031&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877797%26dopt%3DAbstract Authors: Rahman M, Velat GJ, Hoh BL, Mocco J Cerebral venous sinus thrombosis (CVST) is an increasingly diagnosed disease with a wide range of symptoms, ranging from a mild headache to cerebral herniation. A potentially devastating syndrome, CVST has been associated with a mortality rate of 6-10%. In prospective studies, the overall rate of death and dependency from CVST ranges from 8.8 to 44.4%. Systemic anticoagulation remains the first-line treatment. However, a percentage of patients deteriorate despite medical therapy. These cases have resulted in the development of thrombolysis or endovascular treatment for CVST. Initial reports of the use of endovascular treatment of CVST have been promising. However, enthusiasm for the use of endovascular thrombolysis and thrombectomy should be... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955031 Sun, 01 Nov 2009 00:00:00 +0100 2955031 http://www.medworm.com/index.php?rid=2955030&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877798%26dopt%3DAbstract Authors: Hoang S, Choudhri O, Edwards M, Guzman R A vein of Galen malformation is a rare intracranial vascular lesion affecting the pediatric population. Its poor prognosis has been significantly improved with the development of endovascular embolization. In this paper the authors review the developmental mechanisms, clinical pathophysiology, and the available data on the management and outcome of the disease. PMID: 19877798 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955030 Sun, 01 Nov 2009 00:00:00 +0100 2955030 http://www.medworm.com/index.php?rid=2955029&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19877799%26dopt%3DAbstract Authors: Aboian MS, Daniels DJ, Rammos SK, Pozzati E, Lanzino G Recent clinical and experimental evidence has challenged the traditional concept of the venous system as a "passive" element in the genesis and evolution of intracranial vascular malformations. The authors review the clinical and experimental evidence linking the venous system and its anomalies to the genesis of various intracranial vascular malformations, including dural arteriovenous fistulas, cavernous malformations, parenchymal arteriovenous malformations, and capillary telangiectasia. They also describe the potential significance of different associations of these vascular anomalies. PMID: 19877799 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2955029 Sun, 01 Nov 2009 00:00:00 +0100 2955029 http://www.medworm.com/index.php?rid=2859287&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19795948%26dopt%3DAbstract Authors: Fehlings MG, Houldon D, Vajkoczy P PMID: 19795948 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2859287 Wed, 30 Sep 2009 23:00:00 +0100 2859287 http://www.medworm.com/index.php?rid=2859286&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19795949%26dopt%3DAbstract CONCLUSIONS: The AMR should be monitored routinely in the operating room, and surgical decision-making in the operating room should be augmented by the AMR. PMID: 19795949 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2859286 Wed, 30 Sep 2009 23:00:00 +0100 2859286 http://www.medworm.com/index.php?rid=2859285&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19795950%26dopt%3DAbstract Conclusions In this study LASCA offered noninvasive and rapid intraoperative assessment of relative CBF, which can be used for optimizing neurovascular procedures. PMID: 19795950 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2859285 Wed, 30 Sep 2009 23:00:00 +0100 2859285 http://www.medworm.com/index.php?rid=2859284&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19795951%26dopt%3DAbstract CONCLUSIONS: Neurophysiological IOM represents an established tool in neurosurgery. Although the importance of IOM is emphasized by the majority of neurosurgeons, the relevance of this tool to the course of the operation changes with increasing neurophysiological IOM experience. PMID: 19795951 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2859284 Wed, 30 Sep 2009 23:00:00 +0100 2859284 http://www.medworm.com/index.php?rid=2859283&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19795952%26dopt%3DAbstract Authors: Kombos T, Süss O Intraoperative electrical stimulation of the motor cortex is a sensitive method for intraoperative mapping and monitoring of this region. Two different stimulation techniques have been established, the bipolar and monopolar techniques. Controversy exists regarding the most suitable method. Both methods have advantages and disadvantages and different electrophysiological backgrounds. The present study is a review of the electrophysiological basis of direct cortical electrical stimulation of the motor cortex. Both methods are discussed and their field of application is presented. PMID: 19795952 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2859283 Wed, 30 Sep 2009 23:00:00 +0100 2859283 http://www.medworm.com/index.php?rid=2859282&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19795953%26dopt%3DAbstract Authors: Bertani G, Fava E, Casaceli G, Carrabba G, Casarotti A, Papagno C, Castellano A, Falini A, Gaini SM, Bello L Low-grade gliomas ([LGGs] WHO Grade II) are slow-growing intrinsic cerebral lesions that diffusely infiltrate the brain parenchyma along white matter tracts and almost invariably show a progression toward malignancy. The treatment of these tumors forces the neurosurgeon to face uncommon difficulties and is still a subject of debate. At the authors' institution, resection is the first option in the treatment of LGGs. It requires the combined efforts of a multidisciplinary team of neurosurgeons, neuroradiologists, neuropsychologists, and neurophysiologists, who together contribute to the definition of the location, extension, and extent of functional involvement that a sp... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2859282 Wed, 30 Sep 2009 23:00:00 +0100 2859282 http://www.medworm.com/index.php?rid=2859281&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19795954%26dopt%3DAbstract CONCLUSIONS: The technique presented here is a safe method. It allows a quantitative monitoring of motor function and functional mapping of the pyramidal tract during insular surgery. PMID: 19795954 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2859281 Wed, 30 Sep 2009 23:00:00 +0100 2859281 http://www.medworm.com/index.php?rid=2859280&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19795955%26dopt%3DAbstract Authors: Gonzalez AA, Jeyanandarajan D, Hansen C, Zada G, Hsieh PC Spinal surgery involves a wide spectrum of procedures during which the spinal cord, nerve roots, and key blood vessels are frequently placed at risk for injury. Neuromonitoring provides an opportunity to assess the functional integrity of susceptible neural elements during surgery. The methodology of obtaining and interpreting data from various neuromonitoring modalities-such as somatosensory evoked potentials, motor evoked potentials, spontaneous electromyography, and triggered electromyography-is reviewed in this report. Also discussed are the major benefits and limitations of each modality, as well as the strength of each alone and in combination with other modalities, with regard to its sensitivity, specificity, and... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2859280 Wed, 30 Sep 2009 23:00:00 +0100 2859280 http://www.medworm.com/index.php?rid=2859279&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19795956%26dopt%3DAbstract CONCLUSIONS: In general, selecting the appropriate anesthetic regimen with maintenance of a stable concentration of inhalational or intravenous anesthetics optimizes TcMEP monitoring. PMID: 19795956 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2859279 Wed, 30 Sep 2009 23:00:00 +0100 2859279 http://www.medworm.com/index.php?rid=2859278&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19795957%26dopt%3DAbstract CONCLUSIONS: Recent advances in electrophysiological technology have considerably contributed to improvement in functional outcome of vestibular neuroma surgery in terms of hearing preservation and facial nerve paresis. Perioperative intravenous nimodipine and hydroxyethyl starch may be valuable additions to surgery. PMID: 19795957 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2859278 Wed, 30 Sep 2009 23:00:00 +0100 2859278 http://www.medworm.com/index.php?rid=2762259&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722811%26dopt%3DAbstract Authors: Prestigiacomo CJ, Preul MC PMID: 19722811 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762259 Mon, 31 Aug 2009 23:00:00 +0100 2762259 http://www.medworm.com/index.php?rid=2762258&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722812%26dopt%3DAbstract Authors: Baaj AA, Uribe JS, Vale FL, Preul MC, Crawford NR Enthusiasm for cervical disc arthroplasty is based on the premise that motion-preserving devices attenuate the progression of adjacent-segment disease (ASD) in the cervical spine. Arthrodesis, on the other hand, results in abnormal load transfer on adjacent segments, leading to the acceleration of ASD. It has taken several decades of pioneering work to produce clinically relevant devices that mimic the kinematics of the intervertebral disc. The goal of this work is to trace the origins of cervical arthroplasty technology and highlight the attributes of devices currently available in the market. PMID: 19722812 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762258 Mon, 31 Aug 2009 23:00:00 +0100 2762258 http://www.medworm.com/index.php?rid=2762257&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722813%26dopt%3DAbstract Authors: Enchev Y Currently, neuronavigation is an indivisible and indispensable part of the neurosurgical reality with a significant potential impact in each neurosurgical procedure. The history of neuronavigation is quite short (< 3 decades), but full of highly promising achievements. The advent of neuronavigation would be unimaginable without the development of imaging technology, electronics, robotics, and space technology. The history of neuroradiology is reviewed briefly parallel with the detailed evolution of frame-based stereotaxy and its successor-neuronavigation. The historic milestones and the state of the art of neuronavigation are discussed in a genealogical manner. The future trends of neuronavigation as integrated with intraoperative CT, MR, and ultrasonography, as we... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762257 Mon, 31 Aug 2009 23:00:00 +0100 2762257 http://www.medworm.com/index.php?rid=2762256&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722814%26dopt%3DAbstract Authors: Rahman M, Murad GJ, Mocco J Stereotactic neurosurgery has a rich history, beginning with the first stereotactic frame described by Horsley and Clarke in 1908. It is now widely used for delivery of radiation, surgical targeting of electrodes, and resection to treat tumors, epilepsy, vascular malformations, and pain syndromes. These treatments are now available due to the pioneering efforts of neurosurgeons and scientists in the beginning of the 20th century. Their efforts focused on the development of stereotactic instruments for accurate lesion targeting. In this paper, the authors review the history of the stereotactic apparatus in the early 20th century, with a focus on the fascinating people key to its development. PMID: 19722814 [PubMed - in process] (Source: Neurosurg... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762256 Mon, 31 Aug 2009 23:00:00 +0100 2762256 http://www.medworm.com/index.php?rid=2762255&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722815%26dopt%3DAbstract Authors: Rahman M, Murad GJ, Bova F, Friedman WA, Mocco J The search for efficacious, minimally invasive neurosurgical treatment has led to the development of the operating microscope, endovascular treatment, and endoscopic surgery. One of the most minimally invasive and exciting discoveries is the use of targeted, high-dose radiation for neurosurgical disorders. Radiosurgery is truly minimally invasive, delivering therapeutic energy to an accurately defined target without an incision, and has been used to treat a wide variety of pathological conditions, including benign and malignant brain tumors, vascular lesions such as arteriovenous malformations, and pain syndromes such as trigeminal neuralgia. Over the last 50 years, a tremendous amount of knowledge has been garnered, both about ... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762255 Mon, 31 Aug 2009 23:00:00 +0100 2762255 http://www.medworm.com/index.php?rid=2762254&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722816%26dopt%3DAbstract Authors: Cavalcanti DD, Feindel W, Goodrich JT, Dagi TF, Prestigiacomo CJ, Preul MC In the 15th century, brain illustration began to change from a schematic system that involved scant objective rendering of the brain, to accurate depictions based on anatomical dissections that demanded significant artistic talent. Notable examples of this innovation are the drawings of Leonardo da Vinci (1498-1504), Andreas Vesalius' association with the bottega of Titian to produce the drawings of Vesalius' De humani corporis fabrica (1543), and Christopher Wren's illustrations for Thomas Willis' Cerebri Anatome (1664). These works appeared during the Renaissance and Age of Enlightenment, when advances in brain imaging, or really brain rendering, reflected not only the abilities and dedications of the... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762254 Mon, 31 Aug 2009 23:00:00 +0100 2762254 http://www.medworm.com/index.php?rid=2762253&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722817%26dopt%3DAbstract Authors: Bergman WC, Schulz RA, Davis DS For any new technology to gain acceptance, it must not only adequately fill a true need, but must also function optimally within the confines of coexisting technology and concurrently available support systems. As an example, over the first decades of the 20th century, a number of drill designs used to perform cranial bone cuts appeared, fell out of favor, and later reappeared as certain supportive technologies emerged. Ultimately, it was the power source that caused one device to prevail. In contrast, a brilliant imaging device, designed to demonstrate an axial view of the lumbar spine, was never allowed to gain acceptance because it was immediately superseded by another device of no greater innovation, but one that performed optimally with pop... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762253 Mon, 31 Aug 2009 23:00:00 +0100 2762253 http://www.medworm.com/index.php?rid=2762252&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722819%26dopt%3DAbstract Authors: Uluç K, Kujoth GC, Başkaya MK The operating microscope is a fixture of modern surgical facilities, and it is a critically important factor in the success of many of the most complex and difficult surgical interventions used in medicine today. The rise of this key surgical tool reflects advances in understanding the principles of optics and vision that have occurred over centuries. The development of reading spectacles in the late 13th century led to the construction of early compound microscopes in the 16th and 17th centuries by Lippershey, Janssen, Galileo, Hooke, and others. Perhaps surprisingly, Leeuwenhoek's simple microscopes of this era offered improved performance over his contemporaries' designs. The intervening years saw improvements that reduced the spheri... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762252 Mon, 31 Aug 2009 23:00:00 +0100 2762252 http://www.medworm.com/index.php?rid=2762251&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722820%26dopt%3DAbstract Authors: Lulic D, Ahmadian A, Baaj AA, Benbadis SR, Vale FL Vagus nerve stimulation (VNS) is a key tool in the treatment of patients with medically refractory epilepsy. Although the mechanism of action of VNS remains poorly understood, this modality is now the most widely used nonpharmacological treatment for drug-resistant epilepsy. The goal of this work is to review the history of VNS and provide information on recent advances and applications of this technology. PMID: 19722820 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762251 Mon, 31 Aug 2009 23:00:00 +0100 2762251 http://www.medworm.com/index.php?rid=2762250&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722821%26dopt%3DAbstract Authors: Ryan RW, Spetzler RF, Preul MC In this historical review the authors examine the important developments that have led to the availability of laser energy to neurosurgeons as a unique and sometimes invaluable tool. They review the physical science behind the function of lasers, as well as how and when various lasers based on different lasing mediums were discovered. They also follow the close association between advances in laser technology and their application in biomedicine, from early laboratory experiments to the first clinical experiences. Because opinions on the appropriate role of lasers in neurosurgery vary widely, the historical basis for some of these views is explored. Initial enthusiasm for a technology that appears to have innate advantages for safe resections has... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762250 Mon, 31 Aug 2009 23:00:00 +0100 2762250 http://www.medworm.com/index.php?rid=2762249&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722822%26dopt%3DAbstract Authors: Grunert P, Gaab MR, Hellwig D, Oertel JM Endoscopy plays an important part in current minimally invasive neurosurgery. The concepts, indications, and standards of current neuroendoscopy were developed in the beginning of the 1990s by several groups of neurosurgeons. Several factors contributed to its success and acceptance, including technical development, influence of other disciplines, and adaptation to neurosurgical requirements. This historical survey focuses on the period when this technique initially emerged, including the scientific discussions of each group as well as the arguments and reasons that led to present intraventricular neuroendoscopy. Interestingly, despite the almost independent development of neuroendoscopic systems and techniques, the available systems an... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762249 Mon, 31 Aug 2009 23:00:00 +0100 2762249 http://www.medworm.com/index.php?rid=2762248&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722823%26dopt%3DAbstract Authors: Gandhi CD, Christiano LD, Eloy JA, Prestigiacomo CJ, Post KD Over the past century, pituitary surgery has undergone multiple evolutions in surgical technique and technological advancements that have resulted in what practitioners now recognize as modern transsphenoidal surgery (TSS). Although the procedure is now well established in current neurosurgical literature, the historical maze that led to its development continues to be of interest because it allows a better appreciation of the unique contributions by the pioneers of the technique, and of the innovative spirit that continues to fuel neurosurgery. The early events in the history of TSS have already been well documented. This paper therefore summarizes the major early transitions along the timeline, and then further con... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762248 Mon, 31 Aug 2009 23:00:00 +0100 2762248 http://www.medworm.com/index.php?rid=2762247&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19722824%26dopt%3DAbstract In this report the authors present a chronological, historical perspective of minimal access spine technique and minimally invasive technologies in the lumbar, thoracic, and cervical spine from 1967 through 2009. Due to a low rate of complications, minimal soft tissue trauma, and reduced blood loss, more spine procedures are being performed in this manner. Spine surgery now entails shorter hospital stays and often is carried out on an outpatient basis. With education, training, and further research, more of our traditional open surgical management will be augmented or replaced by these technologies and approaches in the future. PMID: 19722824 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2762247 Mon, 31 Aug 2009 23:00:00 +0100 2762247 http://www.medworm.com/index.php?rid=2668646&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645557%26dopt%3DAbstract Authors: Meyer B PMID: 19645557 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2668646 Fri, 31 Jul 2009 23:00:00 +0100 2668646 http://www.medworm.com/index.php?rid=2668645&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645558%26dopt%3DAbstract Authors: Kalani MY, Kalani MA, Gwinn R, Keogh B, Tse VC The human insular cortex, or the lobus insularis, is considered the developmentally most primitive lobe of the telencephalon. Covered by an overlying cortical lid, the insula has functions that are distinct from yet related to those of the adjacent temporal lobe and deep limbic structures. In the first part of this paper the authors outline the development of the human insula, including the cellular heterogeneity comprising the various parts of the insular lobe. Using the understanding gained from the development of the insula they then address implications of insular development for cortical development and connection as well as for tumorigenesis and tumor spread from the insula to other cortical structures, most notably the temp... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2668645 Fri, 31 Jul 2009 23:00:00 +0100 2668645 http://www.medworm.com/index.php?rid=2668644&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645559%26dopt%3DAbstract CONCLUSIONS: The knowledge obtained using the various imaging techniques contributes substantially to understanding the disease processes in a way that drastically improves surgical planning. PMID: 19645559 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2668644 Fri, 31 Jul 2009 23:00:00 +0100 2668644 http://www.medworm.com/index.php?rid=2668643&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645560%26dopt%3DAbstract Authors: Rajneesh KF, Binder DK Tumor-associated epilepsy is an important contributor to morbidity in patients with brain tumors. Proposed pathophysiological mechanisms to explain these effects range from neuronal and glial dysfunction to deranged vascular homeostasis, to ionic and pH changes. Perilesional tissue alterations play a vital role in the generation of tumor-associated seizures. Clinical studies have determined that tumor-associated seizures are usually focal with secondary generalization and often resistant to antiepileptic drugs. Tumor histopathological characteristics and location are independent factors that impact seizure burden. Further understanding of the mechanisms of tumor-associated epilepsy may lead to new types of treatments targeted at perilesional tissue alter... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2668643 Fri, 31 Jul 2009 23:00:00 +0100 2668643 http://www.medworm.com/index.php?rid=2668642&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645561%26dopt%3DAbstract CONCLUSIONS: Surgery is the principal treatment for MTL tumors, despite its technical difficulty. Complete tumor resection is strongly recommended for long-term tumor control. The MTL tumors are heterogeneous in their prognosis. Older age, short duration of epilepsy, and tumor size are all associated with poor outcome. Patients with these characteristics may have a more aggressive form of the disease than those with MTL tumors associated with chronic epilepsy. PMID: 19645561 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2668642 Fri, 31 Jul 2009 23:00:00 +0100 2668642 http://www.medworm.com/index.php?rid=2668641&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645562%26dopt%3DAbstract CONCLUSIONS: The authors' examination of the long-term follow-up data in patients with temporal lobe tumors causing chronic intractable epilepsy demonstrated excellent results in seizure improvement after surgery. PMID: 19645562 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2668641 Fri, 31 Jul 2009 23:00:00 +0100 2668641 http://www.medworm.com/index.php?rid=2668640&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645563%26dopt%3DAbstract CONCLUSIONS: Although insular surgery was long believed to be too risky, the present results show that the rate of permanent deficit, especially dysphasia, following resection of Grade II gliomas involving the dominant insula has been dramatically reduced (none in this patient series), thanks to the systematic use of intraoperative awake mapping, even in cases of repeated operations. Furthermore, patient quality of life may be improved due to a decrease of epilepsy after surgery. Thus, the authors suggest systematically considering resection when an insular Grade II glioma is diagnosed after seizures in a patient with no or mild deficit, even a glioma invading the dominant hemisphere. PMID: 19645563 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2668640 Fri, 31 Jul 2009 23:00:00 +0100 2668640 http://www.medworm.com/index.php?rid=2668639&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19645564%26dopt%3DAbstract CONCLUSIONS: Gliomas arising from the cingulate gyrus are rare. A gross-total resection is often possible and acceptably safe; intraoperative monitoring and neuronavigation are helpful adjuncts. In case of resection of gliomas arising from the anterior cingulate gyrus a supplementary motor area syndrome has to be considered, particularly when the tumor extends to the supracingular cortex. PMID: 19645564 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2668639 Fri, 31 Jul 2009 23:00:00 +0100 2668639 http://www.medworm.com/index.php?rid=2573449&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569884%26dopt%3DAbstract Authors: Patil PG PMID: 19569884 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573449 Tue, 30 Jun 2009 23:00:00 +0100 2573449 http://www.medworm.com/index.php?rid=2573448&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569885%26dopt%3DAbstract CONCLUSIONS: These findings support the conclusion that small regions of cortex investigated by ECoG recording may provide sufficient information about motor intentions to support brain-computer interface operations in the future. Given the small scale of the cortical region required, the requisite implanted array would be minimally invasive in terms of surgical placement of the electrode array. PMID: 19569885 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573448 Tue, 30 Jun 2009 23:00:00 +0100 2573448 http://www.medworm.com/index.php?rid=2573447&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569886%26dopt%3DAbstract CONCLUSIONS: Two-dimensional control signals can be derived from ECoG. Local field potentials as measured by ECoG from subdural grids will be useful as control signals for a brain-machine interface. PMID: 19569886 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573447 Tue, 30 Jun 2009 23:00:00 +0100 2573447 http://www.medworm.com/index.php?rid=2573446&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569887%26dopt%3DAbstract Authors: Scherer R, Zanos SP, Miller KJ, Rao RP, Ojemann JG Electrocorticography (ECoG) offers a powerful and versatile platform for developing brain-computer interfaces; it avoids the risks of brain-invasive methods such as intracortical implants while providing significantly higher signal-to-noise ratio than noninvasive techniques such as electroencephalography. The authors demonstrate that both contra- and ipsilateral finger movements can be discriminated from ECoG signals recorded from a single brain hemisphere. The ECoG activation patterns over sensorimotor areas for contra- and ipsilateral movements were found to overlap to a large degree in the recorded hemisphere. Ipsilateral movements, however, produced less pronounced activity compared with contralateral movements. The author... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573446 Tue, 30 Jun 2009 23:00:00 +0100 2573446 http://www.medworm.com/index.php?rid=2573445&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569888%26dopt%3DAbstract Authors: Blakely T, Miller KJ, Zanos SP, Rao RP, Ojemann JG All previous multiple-day brain-computer interface (BCI) experiments have dynamically adjusted the parameterization between the signals measured from the brain and the features used to control the interface. The authors present the results of a multiple-day electrocorticographic (ECoG) BCI experiment. A patient with a subdural electrode array implanted for seizure localization performed tongue motor tasks. After an initial screening and feature selection on the 1st day, 5 consecutive days of cursor-based feedback were performed with a fixed parameterization. Control of the interface was robust throughout all days, with performance increasing to a stable state in which high-frequency ECoG signal could immediately be translated ... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573445 Tue, 30 Jun 2009 23:00:00 +0100 2573445 http://www.medworm.com/index.php?rid=2573444&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569889%26dopt%3DAbstract Authors: Pancrazio JJ Brain-machine interfaces (BMIs) offer the promise of restoring communication, enabling control of assistive devices, and allowing volitional control of extremities in paralyzed individuals. Working in multidisciplinary teams, neurosurgeons can play an invaluable role in the design, development, and demonstration of novel BMI technology. At the National Institutes of Health, the National Institute of Neurological Disorders and Stroke has a long history of supporting neural engineering and prosthetics efforts including BMI, and these research opportunities continue today. The author provides a brief overview of the opportunities and programs currently available to support BMI projects. PMID: 19569889 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573444 Tue, 30 Jun 2009 23:00:00 +0100 2573444 http://www.medworm.com/index.php?rid=2573443&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569890%26dopt%3DAbstract Authors: Awan NR, Lozano A, Hamani C Deep brain stimulation (DBS) has been used to treat various neurological and psychiatric disorders. Over the years, the most suitable surgical candidates and targets for some of these conditions have been characterized and the benefits of DBS well demonstrated in double-blinded randomized trials. This review will discuss some of the areas of current investigation and potential new applications of DBS. PMID: 19569890 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573443 Tue, 30 Jun 2009 23:00:00 +0100 2573443 http://www.medworm.com/index.php?rid=2573442&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569891%26dopt%3DAbstract Authors: Hu R, Eskandar E, Williams Z Deep brain stimulation (DBS) has become an increasingly popular tool for treating a variety of medically refractory neurological and psychiatric disorders such as Parkinson disease, essential tremor, depression, and obsessive-compulsive disorder. Several targets have been identified for ablation or stimulation based on their anatomical location and presumed function. Areas such as the subthalamic nucleus, globus pallidus, and thalamus, for example, are believed to play a key role in motor control and execution, and they are commonly used in the treatment of motor disorders. Limbic structures such as the cingulate cortex and ventral striatum, believed to be important in motivation, emotion, and higher cognition, have also been targeted for treatment... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573442 Tue, 30 Jun 2009 23:00:00 +0100 2573442 http://www.medworm.com/index.php?rid=2573441&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569892%26dopt%3DAbstract Authors: Leuthardt EC, Schalk G, Roland J, Rouse A, Moran DW The notion that a computer can decode brain signals to infer the intentions of a human and then enact those intentions directly through a machine is becoming a realistic technical possibility. These types of devices are known as brain-computer interfaces (BCIs). The evolution of these neuroprosthetic technologies could have significant implications for patients with motor disabilities by enhancing their ability to interact and communicate with their environment. The cortical physiology most investigated and used for device control has been brain signals from the primary motor cortex. To date, this classic motor physiology has been an effective substrate for demonstrating the potential efficacy of BCI-based control. However, e... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573441 Tue, 30 Jun 2009 23:00:00 +0100 2573441 http://www.medworm.com/index.php?rid=2573440&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569893%26dopt%3DAbstract Authors: Ryu SI, Shenoy KV Direct brain control of a prosthetic system is the subject of much popular and scientific news. Neural technology and science have advanced to the point that proof-of-concept systems exist for cortically-controlled prostheses in rats, monkeys, and even humans. However, realizing the dream of making such technology available to everyone is still far off. Fortunately today there is great public and scientific interest in making this happen, but it will only occur when the functional benefits of such systems outweigh the risks. In this article, the authors briefly summarize the state of the art and then highlight many issues that will directly limit clinical translation, including system durability, system performance, and patient risk. Despite the challenges, s... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573440 Tue, 30 Jun 2009 23:00:00 +0100 2573440 http://www.medworm.com/index.php?rid=2573439&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569894%26dopt%3DAbstract Authors: Pezaris JS, Eskandar EN Common causes of blindness are diseases that affect the ocular structures, such as glaucoma, retinitis pigmentosa, and macular degeneration, rendering the eyes no longer sensitive to light. The visual pathway, however, as a predominantly central structure, is largely spared in these cases. It is thus widely thought that a device-based prosthetic approach to restoration of visual function will be effective and will enjoy similar success as cochlear implants have for restoration of auditory function. In this article the authors review the potential locations for stimulation electrode placement for visual prostheses, assessing the anatomical and functional advantages and disadvantages of each. Of particular interest to the neurosurgical community is placem... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573439 Tue, 30 Jun 2009 23:00:00 +0100 2573439 http://www.medworm.com/index.php?rid=2573438&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569895%26dopt%3DAbstract Authors: Denning T, Matsuoka Y, Kohno T An increasing number of neural implantable devices will become available in the near future due to advances in neural engineering. This discipline holds the potential to improve many patients' lives dramatically by offering improved-and in some cases entirely new-forms of rehabilitation for conditions ranging from missing limbs to degenerative cognitive diseases. The use of standard engineering practices, medical trials, and neuroethical evaluations during the design process can create systems that are safe and that follow ethical guidelines; unfortunately, none of these disciplines currently ensure that neural devices are robust against adversarial entities trying to exploit these devices to alter, block, or eavesdrop on neural signals. The auth... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573438 Tue, 30 Jun 2009 23:00:00 +0100 2573438 http://www.medworm.com/index.php?rid=2573437&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569896%26dopt%3DAbstract CONCLUSIONS: Multifunctional neural probes such as the ones developed and validated within this study have great potential to help further understand the design space and criteria for the next generation of neural probe technology. By incorporating integrated drug delivery functionality into the probes, new treatment options for neurological disorders and regenerative neural interfaces using localized and feedback-controlled delivery of drugs can be realized in the near future. PMID: 19569896 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573437 Tue, 30 Jun 2009 23:00:00 +0100 2573437 http://www.medworm.com/index.php?rid=2573436&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19569897%26dopt%3DAbstract CONCLUSIONS: The nonpenetrating microwire platform showed good potential for allowing differentiated signals to be recorded with high spatial fidelity without cortical penetration. PMID: 19569897 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2573436 Tue, 30 Jun 2009 23:00:00 +0100 2573436 http://www.medworm.com/index.php?rid=2524062&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19485713%26dopt%3DAbstract Authors: Manley GT Elevated intracranial pressure is one of the most common causes of death and disability following severe traumatic brain injury and ischemic stroke. Unfortunately, there have been no new medical treatments for cerebral edema and elevated intracranial pressure in more than 80 years. Decompressive craniectomy may be an appropriate surgical option in the face of elevated intracranial pressure that is refractory to medical treatment. When performed correctly, this procedure can reduce intracranial pressure and prevent cerebral herniation and death. The last decade has seen a renewed interest in the use of decompressive craniectomy, but many questions remain regarding patient selection, timing of surgery, surgical technique, timing of cranioplasty, and complications. ... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524062 Sun, 31 May 2009 23:00:00 +0100 2524062 http://www.medworm.com/index.php?rid=2524061&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19485714%26dopt%3DAbstract CONCLUSIONS: With the aid of CAD technology, all currently used alloplastic materials are suited even for large skull defect cranioplasty. Analysis of the authors' data and the literature shows that cranioplasty with CAD/CAM titanium implants provides the lowest rate of complications, reasonable costs, and acceptable postoperative imaging. Polymethylmethacrylate is suited for primary cranioplasty or for long-term follow-up imaging of tumors. Titanium implants seem to be the material of choice for secondary cranioplasty of large skull defects resulting from decompressive craniectomy after trauma or infarction. Expensive HA-based ceramics show no obvious advantage over titanium or PMMA. PMID: 19485714 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524061 Sun, 31 May 2009 23:00:00 +0100 2524061 http://www.medworm.com/index.php?rid=2524060&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19485715%26dopt%3DAbstract In this study, the authors performed a systematic review of the literature to examine neurological outcome after hemicraniectomy. A literature search revealed 29 studies that reported outcomes using GOS scores. The GOS scores were transformed to utility values for quality of life using a conversion method based on decision analysis modeling. Based on the literature, 1422 cases were analyzed. The average 6-month-postoperative mortality rate was 28.2%. The mean QOL value among survivors was 0.592, which corresponds roughly to a GOS score of 4. Although more studies are needed for validation of long-term neurological outcome after hemicraniectomy, the assumption that most patients remain in a vegetative state after this intervention is clearly incorrect. PMID: 19485715 [PubMed - in proces... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524060 Sun, 31 May 2009 23:00:00 +0100 2524060 http://www.medworm.com/index.php?rid=2524059&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19485716%26dopt%3DAbstract CONCLUSIONS: The mortality rate and functional outcome, as measured by the BI and mRS, were significantly worse in patients > 60 years of age following decompressive craniectomy for malignant infarction. Age is an important factor to consider in patient selection for surgery. However, cautious interpretation of the results is required because the outcome scores that were used only measure physical disability, whereas other factors, including psychosocial, financial, and caregiver burden, should be considered in addition to age alone. PMID: 19485716 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524059 Sun, 31 May 2009 23:00:00 +0100 2524059 http://www.medworm.com/index.php?rid=2524058&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19485717%26dopt%3DAbstract CONCLUSIONS: Based on the data in this study the authors concluded that primary as well as secondary craniectomy might be warranted, regardless of the underlying etiology (hemorrhage, infarction, or brain swelling) and admission clinical grade of the patient. The time from the onset of intractable intracranial pressure to DC seems to be crucial for a favorable outcome, even when a DC is performed late in the disease course after SAH. PMID: 19485717 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524058 Sun, 31 May 2009 23:00:00 +0100 2524058 http://www.medworm.com/index.php?rid=2524057&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19485718%26dopt%3DAbstract Authors: Lanterna LA, Gritti P, Manara O, Grimod G, Bortolotti G, Biroli F Cerebral venous and dural sinus thrombosis (CVDST) is a rare cause of stroke in young and middle-aged adults. When the clinical course is complicated by uncontrollable intracranial hypertension and brainstem compression due to edema or cerebral hemorrhage, the prognosis is poor. The authors evaluated the therapeutic role of surgical decompression in patients with clinical signs of impending herniation. Cerebral venous and dural sinus thrombosis complicated by impending brain herniation a very rare, life-threatening but potentially treatable clinical condition. Three patients with pupillary signs of transtentorial herniation due to brain edema and hemorrhage caused by CVDST (superior sagittal sinus in 1 patient a... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524057 Sun, 31 May 2009 23:00:00 +0100 2524057 http://www.medworm.com/index.php?rid=2524056&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19485719%26dopt%3DAbstract CONCLUSIONS: Hinge craniotomy appears to be at least as good as DC in providing postoperative ICP control and results in equivalent early clinical outcomes. PMID: 19485719 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524056 Sun, 31 May 2009 23:00:00 +0100 2524056 http://www.medworm.com/index.php?rid=2524055&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19485720%26dopt%3DAbstract Authors: Stiver SI Decompressive craniectomy is widely used to treat intracranial hypertension following traumatic brain injury (TBI). Two randomized trials are currently underway to further evaluate the effectiveness of decompressive craniectomy for TBI. Complications of this procedure have major ramifications on the risk-benefit balance in decision-making during evaluation of potential surgical candidates. To further evaluate the complications of decompressive craniectomy, a review of the literature was performed following a detailed search of PubMed between 1980 and 2009. The author restricted her study to literature pertaining to decompressive craniectomy for patients with TBI. An understanding of the pathophysiological events that accompany removal of a large piece of skull bone p... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524055 Sun, 31 May 2009 23:00:00 +0100 2524055 http://www.medworm.com/index.php?rid=2524054&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19485721%26dopt%3DAbstract CONCLUSIONS: High dynamic accidents and patients with diffuse injury were more prone to SDGs. Close to 8% of SDGs converted themselves into subdural hematomas at approximately 2 months postinjury. Although SDGs developed in 39 (approximately 60%) of 68 post-DC patients, surgical evacuation was needed in only 4. PMID: 19485721 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524054 Sun, 31 May 2009 23:00:00 +0100 2524054 http://www.medworm.com/index.php?rid=2524053&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19485722%26dopt%3DAbstract CONCLUSIONS: Cranioplasty following decompressive craniectomy is associated with a high complication rate. Patients undergoing a bifrontal craniectomy are at significantly increased risk for postcranioplasty complications, including the need for reoperation. PMID: 19485722 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524053 Sun, 31 May 2009 23:00:00 +0100 2524053 http://www.medworm.com/index.php?rid=2524088&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408987%26dopt%3DAbstract Authors: Eddleman CS, Batjer HH, Lavine S PMID: 19408987 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524088 Thu, 30 Apr 2009 23:00:00 +0100 2524088 http://www.medworm.com/index.php?rid=2524086&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408988%26dopt%3DAbstract Conclusions Understanding the complicated molecular milieu of developing AVMs is essential for defining their natural history. Growth factors, extracellular matrix proteins, and other molecular markers will be the key to unlocking novel targeted drug treatments for these brain malformations. PMID: 19408988 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524086 Thu, 30 Apr 2009 23:00:00 +0100 2524086 http://www.medworm.com/index.php?rid=2524084&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408989%26dopt%3DAbstract CONCLUSIONS: The dynamic nature of brain AVMs is at least in part attributable to hemodynamic and flow-related phenomena. These forces acting on an evolving structure are critical to understanding the challenges in endovascular and surgical therapy. As knowledge in this field continues to progress, the natural history and predicted behavior of these AVMs will become more clearly elucidated. PMID: 19408989 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524084 Thu, 30 Apr 2009 23:00:00 +0100 2524084 http://www.medworm.com/index.php?rid=2524083&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408990%26dopt%3DAbstract Authors: Arnaout OM, Gross BA, Eddleman CS, Bendok BR, Getch CC, Batjer HH Arteriovenous malformations (AVMs) of the posterior fossa are complex neurovascular lesions that are less common than their supratentorial counterparts, accounting for < 15% of all AVMs. The majority of patients with these lesions present with intracranial hemorrhage, a factor that has been consistently shown to increase one's risk for subsequent bleeding. Studies have additionally shown a posterior fossa or deep AVM location to portend a more aggressive natural history. The authors reviewed the literature on posterior fossa AVMs, finding their annual rupture rates to be as high as 11.6%, an important factor that underscores the importance of aggressive treatment of lesions amenable to intervention as therape... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524083 Thu, 30 Apr 2009 23:00:00 +0100 2524083 http://www.medworm.com/index.php?rid=2524082&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408991%26dopt%3DAbstract This report demonstrates that time-of-flight (TOF) MR angiography is a useful adjunct for planning stereotactic radiosurgery (SRS) of large arteriovenous malformations (AVMs) after staged embolization with Onyx. Onyx (ethylene vinyl copolymer), a recently approved liquid embolic agent, has been increasingly used to exclude portions of large AVMs from the parent circulation prior to SRS. Limiting SRS to regions of persistent arteriovenous shunting and excluding regions eliminated by embolization may reduce unnecessary radiation doses to eloquent brain structures. However, SRS dosimetry planning presents unique challenges after Onyx embolization because it creates extensive artifacts on CT scans, and it cannot be delineated from untreated nidus on standard MR sequences. During the radiosurge... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524082 Thu, 30 Apr 2009 23:00:00 +0100 2524082 http://www.medworm.com/index.php?rid=2524081&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408992%26dopt%3DAbstract This article presents a modification to the existing classification scales of intracranial dural arteriovenous fistulas based on newly published research regarding the relationship of clinical symptoms and outcome. The 2 commonly used scales, the Borden-Shucart and Cognard scales, rely entirely on angiographic features for categorization. The most critical anatomical feature is the identification of cortical venous drainage (CVD; Borden-Shucart Types II and III and Cognard Types IIb, IIa + b, III, IV, and V), as this feature identifies lesions at high risk for future hemorrhage or ischemic neurological injury. Yet recent data has emerged indicating that within these high-risk groups, most of the risk for future injury is in the subgroup presenting with intracerebral hemorrhage or nonhemorr... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524081 Thu, 30 Apr 2009 23:00:00 +0100 2524081 http://www.medworm.com/index.php?rid=2524080&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408993%26dopt%3DAbstract CONCLUSIONS: Endovascular embolization is an increasingly effective therapy in the treatment of spinal DAVFs, and can be used as a definitive intervention in the majority of patients that undergo modern endovascular intervention. A multidisciplinary approach to the treatment of these lesions is required, as surgery is required for refractory cases or those not amenable to embolization. Newer embolic agents, such as Onyx, hold significant promise for future therapy, yet long-term follow-up studies are required. PMID: 19408993 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524080 Thu, 30 Apr 2009 23:00:00 +0100 2524080 http://www.medworm.com/index.php?rid=2524079&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408994%26dopt%3DAbstract Authors: Pham M, Gross BA, Bendok BR, Awad IA, Batjer HH The use of radiosurgery for angiographically occult vascular malformations (AOVMs) is a controversial treatment option for those that are surgically inaccessible or located in eloquent brain. To determine the efficacy of this treatment, the authors reviewed the literature reporting hemorrhage rates, seizure control, and radiation-induced morbidity. They found overall hemorrhage rates of 2-6.4%, overall postradiosurgery hemorrhage rates of 1.6-8%, and stratified postradiosurgery hemorrhage rates of 7.3-22.4% in the period immediately to 2 years after treatment; these latter rates declined to 0.8-5.2% > 2 years after treatment. Of 291 patients presenting with seizure across 16 studies, 89 (31%) attained a seizure-free status and... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524079 Thu, 30 Apr 2009 23:00:00 +0100 2524079 http://www.medworm.com/index.php?rid=2524078&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408995%26dopt%3DAbstract Authors: Hayden MG, Lee M, Guzman R, Steinberg GK Among the relatively few surgeons to be awarded the Nobel Prize was Alexis Carrel, a French surgeon and pioneer in revascularization surgery at the turn of the 20th century. The authors trace the humble beginnings of cerebral revascularization surgery through to the major developments that helped shape the modern practice of cerebral bypass surgery. They discuss the cornerstone studies in the development of this technique, including the Extracranial/Intracranial Bypass Study initiated in 1977. Recent innovations, including modern techniques to monitor cerebral blood flow, microanastomosis techniques, and ongoing trials that play an important role in the evolution of this field are also evaluated. PMID: 19408995 [PubMed - in process]... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524078 Thu, 30 Apr 2009 23:00:00 +0100 2524078 http://www.medworm.com/index.php?rid=2524077&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408996%26dopt%3DAbstract Authors: Baaj AA, Agazzi S, van Loveren H Cerebral revascularization constitutes an important treatment modality in the management of complex aneurysms, carotid occlusion, tumor, and moyamoya disease. Graft selection is a critical step in the planning of revascularization surgery, and depends on an understanding of graft and regional hemodynamics, accessibility, and patency rates. The goal of this review is to highlight some of these properties. PMID: 19408996 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524077 Thu, 30 Apr 2009 23:00:00 +0100 2524077 http://www.medworm.com/index.php?rid=2524076&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408997%26dopt%3DAbstract Authors: Crowley RW, Medel R, Dumont AS Occipital artery to posterior inferior cerebellar artery bypasses remain an important tool for cerebrovascular neurosurgeons, particularly in the management of complex aneurysms of the posterior inferior cerebellar artery requiring proximal occlusion or trapping. The procedure requires meticulous technique and attention to detail. The authors outline their technique for accomplishing this bypass emphasizing nuances for complication avoidance. PMID: 19408997 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524076 Thu, 30 Apr 2009 23:00:00 +0100 2524076 http://www.medworm.com/index.php?rid=2524075&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408998%26dopt%3DAbstract Authors: Lall RR, Eddleman CS, Bendok BR, Batjer HH Aneurysmal subarachnoid hemorrhage continues to have high rates of morbidity and mortality for patients despite optimal medical and surgical management. Due to the fact that aneurysmal rupture can be such a catastrophic event, preventive treatment is desirable for high-risk lesions. Given the variability of the literature evaluating unruptured aneurysms regarding basic patient population, clinical practice, and aneurysm characteristics studied, such as size, location, aspect ratio, relationship to the surrounding vasculature, and the aneurysm hemodynamics, a meta-analysis is nearly impossible to perform. This review will instead focus on the various anatomical and morphological characteristics of aneurysms reported in the literature w... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524075 Thu, 30 Apr 2009 23:00:00 +0100 2524075 http://www.medworm.com/index.php?rid=2524074&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19408999%26dopt%3DAbstract CONCLUSIONS: With the application of a 3D virtual reality planning system, the extent of skin incision and tissue trauma as well as the size of the bone flap was minimal. The closest point of the appropriate donor branch of the STA and the most suitable recipient M(3) or M(4) segment could be preoperatively determined with high accuracy so that the STA-MCA bypass could be safely and effectively performed through an optimally located minicraniotomy with a mean diameter of 22 mm without the need for stereotactic guidance. PMID: 19408999 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524074 Thu, 30 Apr 2009 23:00:00 +0100 2524074 http://www.medworm.com/index.php?rid=2524073&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19409000%26dopt%3DAbstract CONCLUSIONS: The authors' experience with a large series of angiogram-negative SAH patients who had an atypical nonbenign clinical course associated with hydrocephalus, vasospasm, stroke, and mortality differs significantly from previously published case series of angiogram-negative SAH. PMID: 19409000 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524073 Thu, 30 Apr 2009 23:00:00 +0100 2524073 http://www.medworm.com/index.php?rid=2524072&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19409001%26dopt%3DAbstract CONCLUSIONS: Patients with aSAH who had high Hunt and Hess and Fisher grades and low GCS scores showed elevated CRP levels in their CSF and serum. Furthermore, patients developing angiographically proven vasospasm demonstrated significantly elevated CRP levels in serum and CSF, and increased CRP measurements were strongly associated with poor clinical outcome in this cohort. PMID: 19409001 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524072 Thu, 30 Apr 2009 23:00:00 +0100 2524072 http://www.medworm.com/index.php?rid=2524071&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19409002%26dopt%3DAbstract This report presents an illustrative case study and reviews the pathophysiology of angioplasty and restenosis. PMID: 19409002 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524071 Thu, 30 Apr 2009 23:00:00 +0100 2524071 http://www.medworm.com/index.php?rid=2524070&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19409003%26dopt%3DAbstract Authors: Choi R, Andres RH, Steinberg GK, Guzman R Increasing evidence in animal models and clinical trials for stroke, hypoxic encephalopathy for children, and traumatic brain injury have shown that mild hypothermia may attenuate ischemic damage and improve neurological outcome. However, it is less clear if mild intraoperative hypothermia during vascular neurosurgical procedures results in improved outcomes for patients. This review examines the scientific evidence behind hypothermia as a treatment and discusses factors that may be important for the use of this adjuvant technique, including cooling temperature, duration of hypothermia, and rate of rewarming. PMID: 19409003 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524070 Thu, 30 Apr 2009 23:00:00 +0100 2524070 http://www.medworm.com/index.php?rid=2524069&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19409004%26dopt%3DAbstract CONCLUSIONS: Intracranial aneurysms causing mass effect over the anterior optic pathways usually present with complex features. The best treatment option must include not only the aneurysm occlusion but also relief of the mass effect. Microsurgical clip placement with reduction of aneurysmal mass effect achieved improvement in visual ability or recovery from visual impairment, as well as total aneurysm occlusion, in 93.3% of the study group. Therefore, this option is well supported as the first choice of treatment for intracranial aneurysms presenting with mass effect over the anterior visual pathways. PMID: 19409004 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524069 Thu, 30 Apr 2009 23:00:00 +0100 2524069 http://www.medworm.com/index.php?rid=2524068&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19409005%26dopt%3DAbstract Authors: Eddleman CS, Hurley MC, Bendok BR, Batjer HH Most cavernous carotid aneurysms (CCAs) are considered benign lesions, most often asymptomatic, and to have a natural history with a low risk of life-threatening complications. However, several conditions may exist in which treatment of these aneurysms should be considered. Several options are currently available regarding the management of CCAs with resultant good outcomes, namely expectant management, luminal preservation strategies with or without addressing the aneurysm directly, and Hunterian strategies with or without revascularization procedures. In this article, we discuss the sometimes difficult decision regarding whether to treat CCAs. We consider the natural history of several types of CCAs, the clinical presentation, the... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524068 Thu, 30 Apr 2009 23:00:00 +0100 2524068 http://www.medworm.com/index.php?rid=2524067&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19409006%26dopt%3DAbstract Authors: Christiano LD, Gupta G, Prestigiacomo CJ, Gandhi CD Segal and McLaurin first described giant serpentine aneurysms, based on their distinct angiographic features, in 1977. These lesions are >or= 25 mm, partially thrombosed aneurysms with a patent, serpiginous vascular channel that courses through the aneurysm. There is a separate inflow and outflow of the aneurysm, of which the outflow channel supplies brain parenchyma in the territory of the parent vessel. Given the large size, unique neck, and dependent distal vessels, these aneurysms pose a technical challenge in treatment. Initial management has included surgical obliteration, but as endovascular techniques have evolved, treatment options too have expanded. In this review the authors attempt to summarize the existing bod... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524067 Thu, 30 Apr 2009 23:00:00 +0100 2524067 http://www.medworm.com/index.php?rid=2524066&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19409007%26dopt%3DAbstract Authors: Bambakidis NC, Manjila S, Dashti S, Tarr R, Megerian CA Aneurysms of the anterior inferior cerebellar artery (AICA) are relatively rare among intracranial aneurysms. They can occur in 1 of 3 regions of the AICA: 1) craniocaudal (high or low riding), 2) mediolateral-premeatal (proximal), and 3) meatal-postmeatal (distal). The management strategies for treatment differ according to the location and configuration of the aneurysm. The existing body of neurosurgical literature contains articles published on aneurysms arising from the AICA near the basilar artery (BA), intracanalicular/meatal aneurysms, and distal AICA. Several therapeutic options exist, encompassing microsurgical and endovascular techniques. The authors describe a case of treatment involving a large BA-AICA aneurys... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524066 Thu, 30 Apr 2009 23:00:00 +0100 2524066 http://www.medworm.com/index.php?rid=2524065&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19409008%26dopt%3DAbstract CONCLUSIONS: The use of fenestrated aneurysm clips can minimize tedious and potentially dangerous dissection of adherent branch vessels, while maintaining the integrity of structures placed within the clip aperture. The ACoA aneurysms pointing in a superior direction are more likely to require clip fenestration around the A(2) vessel, whereas those pointing in an inferior direction are more likely to require clip fenestration around the A(1) vessel. The parallel approximation of the fenestrated clip blades makes them especially useful in the treatment of large or giant aneurysms. PMID: 19409008 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524065 Thu, 30 Apr 2009 23:00:00 +0100 2524065 http://www.medworm.com/index.php?rid=2524064&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19409009%26dopt%3DAbstract Authors: Ducruet AF, Kellner CP, Connolly ES, Meyers PM Developmental venous anomalies (DVAs) represent a rare cause of intraparenchymal hemorrhage. This case demonstrates an unusual DVA associated with venous hypertension, arteriovenous shunting, and a ruptured transitional aneurysm. The authors describe the first use of embolization as a treatment method for an unstable ruptured transitional aneurysm associated with a DVA. This 33-year-old man suffered acute onset of headache, gait ataxia, and left hemiparesis. Computed tomography brain scans demonstrated a deep paramedian right frontal intraparenchymal hemorrhage. No cavernous malformation was apparent on MR imaging. Diagnostic angiography revealed arteriovenous shunting from the right anterior and middle cerebral arteries to a larg... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524064 Thu, 30 Apr 2009 23:00:00 +0100 2524064 http://www.medworm.com/index.php?rid=2524063&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19409010%26dopt%3DAbstract Authors: Achrol AS, Guzman R, Varga M, Adler JR, Steinberg GK, Chang SD Brain arteriovenous malformations (BAVMs) are an important cause of intracerebral hemorrhage (ICH) in young adults. Biological predictors of future ICH risk are lacking, and controversy exists over previous studies of natural history risk among predominantly ruptured BAVM cohorts. Recent studies have suggested that the majority of BAVMs are now diagnosed as unruptured lesions, and that the risk according to natural history among these lesions may be less than previously assumed. In the first part of this review, the authors discuss available data on the natural history of BAVMs and highlight the need for future studies that aim to develop surrogate biomarkers of disease progression that accurately predict future ri... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2524063 Thu, 30 Apr 2009 23:00:00 +0100 2524063 http://www.medworm.com/index.php?rid=2299387&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19323602%26dopt%3DAbstract Conclusions The application of advanced diagnostics to categorize PNE syndrome origins into 4 major subtypes and the subsequent treatment of each subtype with a tailored strategy greatly improved therapeutic outcomes as compared with those reported when only a single treatment paradigm was applied to all patients. PMID: 19323602 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2299387 Thu, 02 Apr 2009 01:35:03 +0100 2299387 http://www.medworm.com/index.php?rid=2234595&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19249957%26dopt%3DAbstract Authors: Dumont AS, Evans AJ Thetreatment of stroke has rapidly evolved over the past decade, particularly as data concerning the natural history have emerged and endovascular treatment options have matured. Therapies for acute stroke have expanded as intraarterial thrombolysis and mechanical clot retrieval have been validated. Furthermore, angioplasty and stenting of intra- and extracranial vessels have evolved with the development of new devices coupled with increasing operator experience. Endovascular therapy is now a widely accepted treatment option for cerebral ischemia in many clinical situations. PMID: 19249957 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2234595 Thu, 05 Mar 2009 09:26:05 +0100 2234595 http://www.medworm.com/index.php?rid=2234594&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19249958%26dopt%3DAbstract Authors: Gandhi CD, Christiano LD, Prestigiacomo CJ The management of stroke has progressed significantly over the past 2 decades due to successful treatment protocols including intravenous and intraarterial options. The intravenous administration of tissue plasminogen activator within an established treatment window has been proven in large, well-designed studies. The evolution of endovascular strategies for acute stroke has been prompted by the limits of the intravenous treatment, as well as by the desire to demonstrate improved recanalization rates and improved long-term outcomes. The interventional treatment options available today are the intraarterial administration of tissue plasminogen activator and newer antiplatelet agents, mechanical thrombectomy with the MERCI device and th... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2234594 Thu, 05 Mar 2009 09:26:05 +0100 2234594 http://www.medworm.com/index.php?rid=2234593&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19249959%26dopt%3DAbstract Conclusions Combined intracranial angioplasty and stent placement is a potential treatment option in selected patients for the direct revascularization of nonacute intracranial occlusions and near occlusions. Whether this represents a substantial risk reduction compared with the best medical therapy or a long-lasting treatment option is unknown. PMID: 19249959 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2234593 Thu, 05 Mar 2009 09:26:05 +0100 2234593 http://www.medworm.com/index.php?rid=2234592&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19249960%26dopt%3DAbstract Authors: Medel R, Crowley RW, Dumont AS Endovascular cerebral revascularization is becoming a frequently used alternative to surgery for the treatment of atherosclerotic disease, especially in the intracranial circulation where options are limited. Recent literature regarding the equivalent efficacy of carotid artery stenting and carotid endarterectomy in certain patient populations, as well as the recognition of the significant risk for recurrent stroke posed by intracranial lesions, will only serve to amplify this trend. Hyperperfusion syndrome has been well documented in the setting of carotid endarterectomy; however, a paucity of literature exists regarding the incidence, pathophysiology, and management as it relates to percutaneous interventions. The purpose of this review is to o... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=2234592 Thu, 05 Mar 2009 09:26:05 +0100 2234592