MedWorm: Neurosurgery

Beta Amyloid Alters Cognition Even in Healthy AdultsBeta Amyloid Alters Cognition Even in Healthy Adults

Medscape Today Headlines — Mon, 06 Feb 2012 21:33:18 +0100

About 20% of participants older than 60 years in a new study had amyloid accumulations. Medscape Medical News (Source: Medscape Today Headlines)

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Pain Negatively Affects Cognition in FibromyalgiaPain Negatively Affects Cognition in Fibromyalgia

Medscape Today Headlines — Mon, 06 Feb 2012 18:15:26 +0100

Pain decreased mathematical abilities and attention control more than depression, anxiety, fatigue, sleep complaints, or medication use. Medscape Medical News (Source: Medscape Today Headlines)

Spinal Cord Stimulation Effective for HIV NeuropathySpinal Cord Stimulation Effective for HIV Neuropathy

Medscape Today Headlines — Mon, 06 Feb 2012 16:13:25 +0100

This approach should be "a first-line therapy once individuals are identified with this peripheral neuropathic pain process," says researcher. Medscape Medical News (Source: Medscape Today Headlines)

WHO Grade III Anaplastic Meningioma Metastasizing to the Parotid Gland and the Lungs: Case Report and Review of the Literature

Zentralblatt fur Neurochirurgie - Central European Neurosurgery — Mon, 06 Feb 2012 05:00:00 +0100

Cen Eur NeurosurgDOI: 10.1055/s-0032-1304564[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | FREE Full text (Source: Zentralblatt fur Neurochirurgie - Central European Neurosurgery)

An intraoperative multimodal neurophysiologic approach to successful resection of precentral gyrus epileptogenic lesions

Epilepsia — Mon, 06 Feb 2012 05:00:00 +0100

We present an illustrative case of intractable epilepsy where judicious use of intraoperative neurophysiologic–techniques guided resection of precentral CD, under general anesthesia and in the absence of preoperative electrophysiologic mapping data. Ictal onset was accurately delineated using electrocorticography (ECoG). Phase reversal of the median somatosensory‐evoked potentials (MSSEPs) localized the central sulcus (CS). Motor evoked potentials (MEPs) triggered by high‐frequency monopolar anodal electrical cortical stimulation at the primary motor cortex (PMC) threshold delineated the PMC. Using this technique, PMC and the corticospinal tract (CST) were continuously monitored during resection. No changes in MEPs from the preresection baseline were seen; no residual abnormal activi...

A Patient With ALS and Atypical Clinical FeaturesA Patient With ALS and Atypical Clinical Features

Medscape Today Headlines — Mon, 06 Feb 2012 04:00:00 +0100

The presentation of amyotrophic lateral sclerosis can be variable, and proper diagnosis is essential for prognosis and management. In this case, symptoms were atypical, and diagnosis came too late. Journal of Medical Case Reports (Source: Medscape Today Headlines)

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Solitaire Clot Retrieval Device Outperforms Merci in StrokeSolitaire Clot Retrieval Device Outperforms Merci in Stroke

Medscape Today Headlines — Mon, 06 Feb 2012 01:17:59 +0100

The study was halted early because of numerous significant improvements with the Solitaire device. Medscape Medical News (Source: Medscape Today Headlines)

What Are the Major Diseases Involving Copper Metabolism?

PediatricEducation.org — Mon, 06 Feb 2012 00:08:49 +0100

Discussion Nutritional problems can occur in all parts of the world and in all socioeconomic strata. Caloric and/or protein inadequacy unfortunately plagues too many people because of inadequate supplies or availability. Supplemental food programs around the world attempt to provide appropriate nutrition, but can be stymied because of war, political instability, economic instability and many other social factors. The most common specific nutrient deficiencies are iron and Vitamin D deficiencies. Minerals important for essential nutrition include copper, iodine, selenium and zinc. A typical mixed diet usually provides enough minerals. In the United States, mineral deficiencies are usually uncommon unless there is an underlying disease process or abnormal food restrictions or diet. Vegan an...

WSSF Society News

Stereotactic and Functional Neurosurgery — Sun, 05 Feb 2012 23:00:00 +0100

Stereotact Funct Neurosurg 2012;90:66 (DOI:10.1159/000336392) (Source: Stereotactic and Functional Neurosurgery)

ASSFN Society News

Stereotactic and Functional Neurosurgery — Sun, 05 Feb 2012 23:00:00 +0100

Stereotact Funct Neurosurg 2012;90:67 (DOI:10.1159/000336394) (Source: Stereotactic and Functional Neurosurgery)

ESSFN Mission

Stereotactic and Functional Neurosurgery — Sun, 05 Feb 2012 23:00:00 +0100

Stereotact Funct Neurosurg 2012;90:68 (DOI:10.1159/000336396) (Source: Stereotactic and Functional Neurosurgery)

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Front & Back Matter

Stereotactic and Functional Neurosurgery — Sun, 05 Feb 2012 23:00:00 +0100

Stereotact Funct Neurosurg 2012;90:X (DOI:10.1159/000337008) (Source: Stereotactic and Functional Neurosurgery)

Treating Brain Injuries With Stem Cell Transplants - Promising Results

Health News from Medical News Today — Sat, 04 Feb 2012 18:00:00 +0100

The February edition of Neurosurgery reports that animal experiments in brain-injured rats have shown that stem cells injected via the carotid artery travel directly to the brain, greatly enhancing functional recovery... (Source: Health News from Medical News Today)

Study Looks At Reasons For Lack Of Improvement In Outcomes For Treatment Of Unruptured Brain Aneurysms

Health News from Medical News Today — Sat, 04 Feb 2012 08:00:00 +0100

Despite advances in the diagnosis and treatment of unruptured brain aneurysms, outcomes have remained stagnant over the last 10 years. This can be explained by the dramatic proliferation of minimally invasive endoscopic coiling procedures at lower-volume community hospitals, where outcomes are inferior. These findings are reported in a study by neurologists, neurosurgeons and neuro-anesthesiologists at NewYork-Presbyterian Hospital/Columbia University Medical Center and published in the journal Stroke... (Source: Health News from Medical News Today)

Brain Blood Flow And Oxygen Monitored By First-Of-Its-Kind Head Patch

Health News from Medical News Today — Sat, 04 Feb 2012 08:00:00 +0100

A research team led by investigators at Mayo Clinic in Florida has found that a small device worn on a patient's brow can be useful in monitoring stroke patients in the hospital. The device measures blood oxygen, similar to a pulse oximeter, which is clipped onto a finger. Their study, published in Neurosurgical Focus, suggests this tool, known as frontal near-infrared spectroscopy (NIRS), could offer hospital physicians a safe and cost-effective way to monitor patients who are being treated for a stroke, in real time... (Source: Health News from Medical News Today)

Aspirin as Effective as Warfarin in Heart Failure: WARCEFAspirin as Effective as Warfarin in Heart Failure: WARCEF

Medscape Today Headlines — Fri, 03 Feb 2012 20:47:09 +0100

Although there was an edge for warfarin for those treated for 4 or more years, there is "no compelling" reason to anticoagulate these patients, researchers say. Medscape Medical News (Source: Medscape Today Headlines)

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No Stroke Prevention Benefit of Clopidogrel Plus AspirinNo Stroke Prevention Benefit of Clopidogrel Plus Aspirin

Medscape Today Headlines — Fri, 03 Feb 2012 20:02:42 +0100

A new study shows that the combination clopidogrel and aspirin increases risk of hemorrhage and mortality including non-vascular mortality vs aspirin alone. Medscape Medical News (Source: Medscape Today Headlines)

Continuous Near-Infrared Regional Cerebral Perfusion Monitoring Shows Promise in Stroke Patients

Medgadget Anesthesiology — Fri, 03 Feb 2012 16:47:02 +0100

Researchers at Mayo Clinic in Florida have shown that cerebral optically-based near infra-red spectroscopic oximetry applied to patients who have suffered a stroke can help monitor regional cerebral perfusion in real time, and thus “may serve as a useful, noninvasive, bedside intensive care unit monitoring tool to assess brain oxygenation in a direct manner.” The study looked at the device called Fore-Sight from Casmed of Branford, CT, that measures blood oxygen, similar to a finger clip pulse oximeter. The Mayo study results have been published in Journal of Neurosurgery this month.Regional cerebral blood flow monitoring devices such as Fore-Sight are already in wide deployment in cardiac surgery, where they are thought to prevent brain ischemia in patients undergoing major s...

Single low dose adjuvant Gamma knife radiosurgery for Thyrotropin secreting pituitary adenoma

Acta Neurochirurgica — Fri, 03 Feb 2012 07:21:36 +0100

Content Type Journal ArticleCategory Letter to the editorPages 1-2DOI 10.1007/s00701-012-1284-6Authors Manish K. Kasliwal, Department of Neurosurgery and Gamma Knife Neurosciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India 110029Aditya Gupta, Department of Neurosurgery and Gamma Knife Neurosciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India 110029Manish S. Sharma, Department of Neurosurgery and Gamma Knife Neurosciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India 110029 Journal Acta NeurochirurgicaOnline ISSN 0942-0940Print ISSN 0001-6268 (Source: Acta Neurochirurgica)

Types and severity of operated supraclavicular brachial plexus injuries caused by traffic accidents

Acta Neurochirurgica — Fri, 03 Feb 2012 07:21:35 +0100

Conclusion Study results indicate that the most common injury was an upper plexus palsy. It was characteristic of bicycle accidents, and significantly more common in car and motorcycle accidents. The results also indicate that it is important to consider the potential of a brachial plexus injury after serious traffic accidents and to examine both upper extremities in detail even if some motor function is preserved. Content Type Journal ArticleCategory Clinical ArticlePages 1-5DOI 10.1007/s00701-012-1291-7Authors Radek Kaiser, Third Faculty of Medicine, Department of Neurosurgery, Hospital Kralovske Vinohrady, Charles University, Srobarova 50, 100 34 Prague, Czech RepublicPetr Waldauf, Third Faculty of Medicine, Department of Anesthesiology and Critical Care Medicin...

Brain Tissue Oxygenation and Cerebral Perfusion Pressure Thresholds of Ischemia in a Standardized Pig Brain Death Model

Neurocritical Care — Fri, 03 Feb 2012 07:21:15 +0100

Conclusions A severe increase of ICP leading to CPP below 30 mmHg and BtipO2 below 10 mmHg is associated with an increase of the L/P ratio, thus seems to be critical thresholds for cerebral ischemia under these conditions. Content Type Journal ArticleCategory Translational ResearchPages 1-8DOI 10.1007/s12028-012-9675-3Authors Karlis Purins, Department of Neuroscience, Section of Neurosurgery, Uppsala University, 751 85 Uppsala, SwedenPer Enblad, Department of Neuroscience, Section of Neurosurgery, Uppsala University, 751 85 Uppsala, SwedenLars Wiklund, Department of Surgical Sciences, Section of Anaesthesia and Intensive Care, Uppsala University, Uppsala, SwedenAnders Lewén, Department of Neuroscience, Section of Neurosurgery, Uppsala University, 751 85 Up...

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Rapid Assessment of Sleep-Wake Behavior in Mice

Journal of Biological Rhythms — Fri, 03 Feb 2012 05:00:00 +0100

Sleep is a fundamental biological rhythm involving the interaction of numerous brain structures and diverse neurotransmitter systems. The primary measures used to define sleep are the electroencephalogram (EEG) and electromyogram (EMG). However, EEG-based methods are often unsuitable for use in high-throughput screens as they are time-intensive and involve invasive surgery. As such, the dissection of sleep mechanisms and the discovery of novel drugs that modulate sleep would benefit greatly from further development of rapid behavioral assays to assess sleep in animal models. Here is described an automated noninvasive approach to evaluate sleep duration, latency, and fragmentation using video tracking of mice in their home cage. This approach provides a high correlation with EEG/EMG measure...

Dexpramipexole in ALS: Cautious OptimismDexpramipexole in ALS: Cautious Optimism

Medscape Today Headlines — Fri, 03 Feb 2012 04:00:00 +0100

Might the experimental drug dexpramipexole slow disease progression in ALS? Results of a Phase II trial are promising. Journal Watch (Source: Medscape Today Headlines)

Cardiac Telemetry Identifies Atrial Fibrillation in Cryptogenic Stroke Cardiac Telemetry Identifies Atrial Fibrillation in Cryptogenic Stroke

Medscape Today Headlines — Fri, 03 Feb 2012 01:18:21 +0100

Outpatient monitoring for 21 days detected atrial fibrillation in 17% of patients, and this could change management. Medscape Medical News (Source: Medscape Today Headlines)

Prognostic Significance of Angiogenesis in Relation to Ki-67, p-53, p-27, and bcl-2 Expression in Embryonal Tumors

Pediatric Neurosurgery — Thu, 02 Feb 2012 23:00:00 +0100

Pediatr Neurosurg (DOI:10.1159/000335398) (Source: Pediatric Neurosurgery)

Improved Outcomes in Acute Stroke: An Effective ProtocolImproved Outcomes in Acute Stroke: An Effective Protocol

Medscape Today Headlines — Thu, 02 Feb 2012 21:18:39 +0100

Dr. Hans-Cristoph Diener looks at the impact of evidence-based management protocols in fever, hyperglycemia, and swallowing dysfunction associated with acute stroke. Medscape Neurology (Source: Medscape Today Headlines)

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Severe Anemia Potent Predictor of Death After StrokeSevere Anemia Potent Predictor of Death After Stroke

Medscape Today Headlines — Thu, 02 Feb 2012 21:08:51 +0100

Study results should prompt physicians to take a closer look at what’s causing anemia in stroke patients. Medscape Medical News (Source: Medscape Today Headlines)

High Rate of Sleep Apnea in Patients With Silent StrokesHigh Rate of Sleep Apnea in Patients With Silent Strokes

Medscape Today Headlines — Thu, 02 Feb 2012 20:22:42 +0100

A new study finds half of patients with clinically silent stroke and a third of those with microvascular changes have sleep apnea. Medscape Medical News (Source: Medscape Today Headlines)

Cardinal Health Releases Smart-Seal Surgical Mask

Medgadget Anesthesiology — Thu, 02 Feb 2012 19:11:23 +0100

Cardinal Health has made available its Smart-Seal surgical mask that improves both its fit and reduces interior fogging while providing a high level of filtration and resistance to liquids.From the announcement:Read More (Source: Medgadget Anesthesiology)

An essential role for p38 MAPK in cerebellar granule neuron precursor proliferation

Acta Neuropathologica — Thu, 02 Feb 2012 18:15:33 +0100

Abstract Development of the cerebellum occurs postnatally and is marked by a rapid proliferation of cerebellar granule neuron precursors (CGNPs). CGNPs are the cells of origin for SHH-driven medulloblastoma, the most common malignant brain tumor in children. Here, we investigated the role of ERK, JNK, and p38 mitogen-activated protein kinases in CGNP proliferation. We found high levels of p38α in proliferating CGNPs. Concomitantly, members of the p38 pathway, such as ASK1, MKK3 and ATF-2, were also elevated. Inhibition of the Shh pathway or CGNP proliferation blunts p38α levels, irrespective of Shh treatment. Strikingly, p38α levels were high in vivo in the external granule layer of the postnatal cerebellum, Shh-dependent mouse medulloblastomas and human medulloblastoma...

Computer-aided volumetric analysis as a sensitive tool for the management of incidental meningiomas

Acta Neurochirurgica — Thu, 02 Feb 2012 18:14:22 +0100

Conclusion Overall, we found that computer-aided perimeter methods showed a more accurate picture of tumor progression than traditional methods, which generally underestimated growth. Content Type Journal ArticleCategory Clinical ArticlePages 1-9DOI 10.1007/s00701-012-1273-9Authors Victor Chang, Department of Neurosurgery, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI 48202, USAJayang Narang, Department of Radiology Neuroscience Institute, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI 48202, USALonni Schultz, Department of Biostatistics and Research Epidemiology, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI 48202, USAAhmad Issawi, Department of Neurosurgery, University of Illinois, Peoria, IL, USARajan Jain, Department of Neurosurger...

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Frequency of mutations in the genes associated with hereditary sensory and autonomic neuropathy in a UK cohort

Journal of Neurology — Thu, 02 Feb 2012 18:12:30 +0100

Abstract The hereditary sensory and autonomic neuropathies (HSAN, also known as the hereditary sensory neuropathies) are a clinically and genetically heterogeneous group of disorders, characterised by a progressive sensory neuropathy often complicated by ulcers and amputations, with variable motor and autonomic involvement. To date, mutations in twelve genes have been identified as causing HSAN. To study the frequency of mutations in these genes and the associated phenotypes, we screened 140 index patients in our inherited neuropathy cohort with a clinical diagnosis of HSAN for mutations in the coding regions of SPTLC1, RAB7, WNK1/HSN2, FAM134B, NTRK1 (TRKA) and NGFB. We identified 25 index patients with mutations in six genes associated with HSAN (SPTLC1, RAB7, WNK1/HSN2, F...

Acute Treatment Options for Spinal Cord Injury

Current Treatment Options in Neurology — Thu, 02 Feb 2012 18:12:19 +0100

Opinion statement Most treatment options for acute traumatic spinal cord injury (SCI) are directed at minimizing progression of the initial injury and preventing secondary injury. Failure to adhere to certain guiding principles can be detrimental to the long-term neurologic and functional outcome of these patients. Therapy for the hyperacute phase of traumatic SCI focuses on stabilizing vital signs and follows the Advanced Trauma Life Support (ATLS) algorithm for ensuring stability of airway, breathing and circulation, and disability (neurologic evaluation)—with spinal stabilization—and exposure. Spinal stabilization, with cervical collars and long backboards, is used to prevent movement of a potentially unstable spinal column injury to prevent further injury to the sp...

Relationship between kidney damage and stroke types in Japanese patients

Clinical and Experimental Nephrology — Thu, 02 Feb 2012 18:12:09 +0100

Conclusions This study shows that kidney damage is common in Japanese stroke patients, and proteinuria and renal insufficiency are differentially related to development and prognosis, depending stroke types. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s10157-012-0594-6Authors Kosuke Kudo, Department of Nephrology, Yamagata City Hospital Saiseikan, Yamagata, JapanTsuneo Konta, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585 JapanNoriyuki Degawa, Department of Nephrology, Yamagata City Hospital Saiseikan, Yamagata, JapanShinjiro Saito, Department of Neurosurgery, Yamagata City Hospital Saiseikan, Yamagata, JapanRei Kondo, Department of Neurosurgery, Yamagat...

A meningioma with peripheral rim enhancement on MRI

Brain Tumor Pathology — Thu, 02 Feb 2012 18:12:00 +0100

Abstract Meningiomas are common, typically benign intracranial neoplasms with well-demarcated borders. Meningiomas with indistinct boundaries have been reported. These can invade surrounding structures, and present surgical and diagnostic challenges. We present the case of an unusual meningioma in a 53-year-old male in which preoperative magnetic resonance imaging (MRI) revealed an irregular lesion with clear boundaries and peripheral rim enhancement. Intraoperatively, however, no cleavage plane was apparent. Histological examination showed an increase of fibroconnective tissue with proliferation of dilated vessels in the periphery of the tumor concordant with the rim. Immunohistochemical staining of the tumor was positive for EMA and CD34, but negative for CEA, Ki67, and ...

Deep-Brain Stimulation in Parkinson Disease: 10-Year OutcomesDeep-Brain Stimulation in Parkinson Disease: 10-Year Outcomes

Medscape Today Headlines — Thu, 02 Feb 2012 17:26:49 +0100

A blinded study seeks to determine whether the benefits of deep-brain stimulation in Parkinson disease are sustained over the long term. Medscape Neurology (Source: Medscape Today Headlines)

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Severe, Rapid Memory Loss Could Herald StrokeSevere, Rapid Memory Loss Could Herald Stroke

Medscape Today Headlines — Thu, 02 Feb 2012 17:18:34 +0100

A new study finds that fatal stroke victims had sharp memory declines before event. Medscape Medical News (Source: Medscape Today Headlines)

Anterolateral Mini Fronto-Orbito-Zygomatic Craniotomy via an Eyebrow Incision in Pediatrics: Technical Notes and Evaluation

Karger Publishers — Thu, 02 Feb 2012 12:48:14 +0100

Pediatr Neurosurg (DOI:10.1159/000335399) (Source: Karger Publishers)

Protective Effects of Edaravone on Experimental Spinal Cord Injury in Rats

Karger Publishers — Thu, 02 Feb 2012 12:48:14 +0100

Pediatr Neurosurg (DOI:10.1159/000335400) (Source: Karger Publishers)

Surveillance Study of Healthcare-Associated Infections in a Pediatric Neurosurgery Unit in Italy

Karger Publishers — Thu, 02 Feb 2012 12:48:14 +0100

Pediatr Neurosurg (DOI:10.1159/000335401) (Source: Karger Publishers)

Recombinant Human Bone Morphogenetic Protein-2 as an Adjunct for Spine Fusion in a Pediatric Population

Karger Publishers — Thu, 02 Feb 2012 12:48:14 +0100

Pediatr Neurosurg (DOI:10.1159/000335424) (Source: Karger Publishers)

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Retroclival Epidural Hematoma in a Child Affected by Whiplash Cervical Injury: A Typical Case of a Rare Condition

Karger Publishers — Thu, 02 Feb 2012 12:48:14 +0100

Pediatr Neurosurg (DOI:10.1159/000335446) (Source: Karger Publishers)

Chiari III Malformation

Karger Publishers — Thu, 02 Feb 2012 12:48:14 +0100

Pediatr Neurosurg (DOI:10.1159/000335651) (Source: Karger Publishers)

The relation between zoledronic acid infusion and interbody fusion in patients undergoing transforaminal lumbar interbody fusion surgery

Acta Neurochirurgica — Thu, 02 Feb 2012 06:55:58 +0100

Conclusions There was no association between ZOL treatment and nonunion of the lumbar spinal bone. Thus, undergoing lumbar interbody fusion surgery is not a valid reason to suspend or avoid treatment with ZOL. Content Type Journal ArticleCategory Clinical ArticlePages 1-8DOI 10.1007/s00701-012-1283-7Authors Chao Li, Department of Orthopedics, Zhongshan Hospital, Fudan University, Shanghai, ChinaHui-Ren Wang, Department of Orthopedics, Zhongshan Hospital, Fudan University, Shanghai, ChinaXi-Lei Li, Department of Orthopedics, Zhongshan Hospital, Fudan University, Shanghai, ChinaXiao-Gang Zhou, Department of Orthopedics, Zhongshan Hospital, Fudan University, Shanghai, ChinaJian Dong, Department of Orthopedics, Zhongshan Hospital, Fudan University, Shanghai, China ...

GM-CSF protects rat photoreceptors from death by activating the SRC-dependent signalling and elevating anti-apoptotic factors and neurotrophins

Graefe's Archive for Clinical and Experimental Ophthalmology — Thu, 02 Feb 2012 06:54:33 +0100

Conclusions The data suggest that GM-CSF is a potent therapeutic agent in photoreceptor degeneration caused by mutation of the receptor tyrosine kinase gene (Mertk), and may be also effective in other photoreceptor degeneration. Content Type Journal ArticleCategory Basic SciencePages 1-14DOI 10.1007/s00417-012-1932-9Authors Maurice Schallenberg, Department of Experimental Ophthalmology, School of Medicine, University Eye Hospital Münster and Interdisciplinary Centre for Clinical Research (IZKF), Domagkstrasse 15, 48149 Münster, GermanyPetar Charalambous, Department of Experimental Ophthalmology, School of Medicine, University Eye Hospital Münster and Interdisciplinary Centre for Clinical Research (IZKF), Domagkstrasse 15, 48149 Münster, GermanySolon Thanos, Depar...

Genetic screening of Greek patients with Huntington's disease phenocopies identifies an SCA8 expansion

Journal of Neurology — Thu, 02 Feb 2012 06:54:08 +0100

In this study we screened a cohort of 21 Greek patients with HD phenocopy syndromes for mutations causing HDL2, SCA17, SCA1, SCA2, SCA3, SCA8, SCA12 and DRPLA. Fifteen patients (71%) had a positive family history. We identified one patient (4.8% of the total cohort) with an expansion of 81 combined CTA/CTG repeats at the SCA8 locus. This falls within what is believed to be the high-penetrance allele range. In addition to the classic HD triad, the patient had features of dystonia and oculomotor apraxia. There were no cases of HDL2, SCA17, SCA1, SCA2, SCA3, SCA12 or DRPLA. Given the controversy surrounding the SCA8 expansion, the present finding may be incidental. However, if pathogenic, it broadens the phenotype that may be associated with SCA8 expansions. The absence of any other mut...

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Visualization versus Neuromonitoring of Recurrent Laryngeal Nerves during Thyroidectomy: What About the Costs?

World Journal of Surgery — Thu, 02 Feb 2012 06:53:59 +0100

Conclusions The regional DRG tariff for thyroid surgery is barely sufficient to cover conventional surgery costs. Intraoperative neural monitoring accounts for 5–7% of the hospitalization costs for a thyroidectomy. Content Type Journal ArticlePages 1-7DOI 10.1007/s00268-012-1452-0Authors Gianlorenzo Dionigi, Department of Surgical Sciences, Endocrine Surgery Research Center, University of Insubria Varese-Como, Via Guicciardini, 21100 Varese, ItalyAlessandro Bacuzzi, Department of Anesthesia, University of Insubria, 21100 Varese, ItalyLuigi Boni, Department of Surgical Sciences, Endocrine Surgery Research Center, University of Insubria Varese-Como, Via Guicciardini, 21100 Varese, ItalyStefano Rausei, Department of Surgical Sciences, Endocrine Surgery Research Center...

Clazosentan Reduces Vasospasm After Subarachnoid HemorrhageClazosentan Reduces Vasospasm After Subarachnoid Hemorrhage

Medscape Today Headlines — Wed, 01 Feb 2012 22:33:34 +0100

However, clinical outcomes, including neurological deficits, were not improved. Medscape Medical News (Source: Medscape Today Headlines)

Neurologists Weigh in on Tourette's-Like 'Mystery Illness'Neurologists Weigh in on Tourette's-Like 'Mystery Illness'

Medscape Today Headlines — Wed, 01 Feb 2012 21:38:23 +0100

Experts say conversion disorder explains the symptoms experienced by a cluster of girls at a New York school, but environmentalists question chemical spill. Medscape Medical News (Source: Medscape Today Headlines)

Restenosis Similar With Carotid Stenting or Surgery: CRESTRestenosis Similar With Carotid Stenting or Surgery: CREST

Medscape Today Headlines — Wed, 01 Feb 2012 19:18:43 +0100

At 2 years, carotid restenosis is infrequent and appears similar whether patients were treated with carotid stenting or endarterectomy. Medscape Medical News (Source: Medscape Today Headlines)

Stenting, Surgery Appear Comparable for Opening Neck Artery

The Doctors Lounge - Cardiology — Wed, 01 Feb 2012 18:00:00 +0100

Re-blockage rates similar for both procedures, study finds (Source: The Doctors Lounge - Cardiology)

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Treatment of Neurocritical Care Emergencies in Pregnancy

Current Treatment Options in Neurology — Wed, 01 Feb 2012 17:14:15 +0100

Opinion statement Neurologic emergencies are a major cause of morbidity and mortality in pregnant women. In part because the patient population is young, the nihilistic approach that often accompanies neurologically devastating disorders in other contexts is largely absent. A number of studies have demonstrated improved patient outcomes in the setting of aggressive care delivered by neurointensivists in a specialty-specific environment. It stands to reason that young, pregnant women who suffer from neurologically devastating disorders and who have a wide range of prognosis may also benefit from such specialized care. Close collaboration between obstetricians and neurointensivists is critical in this context. A number of unique considerations in diagnosis and management pre...

Management of Smell Dysfunction

Current Allergy and Asthma Reports — Wed, 01 Feb 2012 17:13:10 +0100

Abstract Olfaction is an essential chemosensory system in the living world. Although less appreciated in humans, smell impairment significantly affects many aspects of quality of life. Smell disorders may be caused by an impaired nasal airway or by lesions in the olfactory system, leading to reduced or distorted smell perception. The most common causes of smell disorders are aging, upper respiratory tract infection, sinonasal disease, and head trauma. Recovery is rarely complete. Counseling is important in progressive or severe smell loss. In patients with distorted smell perception, antidepressant medication is sometimes necessary. Best response to treatment is achieved for nasal obstruction and sinonasal inflammatory disease. Treatment of olfactory impairment caused by s...

Central apnea after adenotonsillectomy in childhood: case report

Sleep and Breathing — Wed, 01 Feb 2012 17:12:46 +0100

Content Type Journal ArticleCategory Case ReportPages 1-6DOI 10.1007/s11325-011-0634-6Authors Leila Azevedo de Almeida, Department of Neuroscience and Behavioral Sciences—Neurology Division, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, BrazilAlan Luiz Eckeli, Department of Neuroscience and Behavioral Sciences—Neurology Division, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, BrazilWilma Terezinha Anselmo Lima, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto School of Medicine, University of São Paulo, Av. Bandeirantes, 3900, CEP: 14048-900 Ribeirão Preto, SP, BrazilEdgard Camilo de Oliveira Filho, Cardiology Division, Ribeirão Preto School of Medicine, University...

Toluidine blue for the intraoperative staining of the ureters. Studies on the safe administration in rats

Langenbeck's Archives of Surgery — Wed, 01 Feb 2012 17:11:57 +0100

Conclusions In rats, intravenous injection of 0.4 mg TB/kg was sufficient for the intraoperative staining of the urinary tract without the risk of severe cardiovascular and hemodynamic side effects. Provided our results are transferable to humans, the administration of low TB doses could allow its safer clinical use for the intraoperative visualization of the ureters. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00423-012-0907-yAuthors Frank Petrat, Institut für Physiologische Chemie, Universitätsklinikum, Universität Duisburg-Essen, Hufelandstr. 55, 45122 Essen, GermanyMatthias Hartmann, Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstr. 55, 45122 Essen, GermanyErnst Schmidt, Dr. F...

Stroke Risk Linked to Infections in ChildrenStroke Risk Linked to Infections in Children

Medscape Today Headlines — Wed, 01 Feb 2012 15:18:43 +0100

A new study finds the risk is highest near the time of infection, then tapers off. Medscape Medical News (Source: Medscape Today Headlines)

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Secrets of the inner voice unlocked

NHS News Feed — Wed, 01 Feb 2012 10:19:00 +0100

Conclusion This study of 15 people undergoing brain surgery has demonstrated a method of reconstructing the sound of a heard word using only the signals obtained from the brain. This study represents an important progression in the field of speech reconstruction, which has the potential to improve the lives of many who suffer from speech difficulties in the future. But the words, when reconstructed, were not of good enough quality to be recognised by a human listener when played. The words could only be identified when the original and reconstructed sound patterns were compared visually. The researchers suggest that improving the brain sensors detecting the STG brain activity may, in the future, improve the reconstructed sound to a level that could be understood by a person listening. The ...

Cancellation of elective operations on the day of intended surgery in a Hong Kong hospital: point prevalence and reasons.

Hong Kong Med J — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS. Case cancellations were mainly due to facility factors, such as no operating room time being available. The odds of having no operating room time available varied between surgical specialties. PMID: 22302904 [PubMed - in process] (Source: Hong Kong Med J)

Postoperative Headache Following Acoustic Neuroma Resection: Occipital Nerve Injuries Are Associated With a Treatable Occipital Neuralgia.

Headache — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion.- In contradistinction to previous reports, we have identified a subset of patients in whom the syndrome of postoperative headache appears directly related to the presence of occipital nerve injuries. In patients with postoperative headache meeting diagnostic criteria for occipital neuralgia, occipital nerve excision appears to provide relief of the headache syndrome and meaningful improvement in quality of life. Further studies are needed to confirm these results and to determine whether occipital nerve injury may present as headache types other than occipital neuralgia. These findings suggest that patients presenting with chronic postoperative headache should be screened for the presence of surgically treatable occipital nerve injuries. PMID: 22296035 [PubMed - as supplied...

Endovascular intervention for acute stroke due to infective endocarditis.

Neurosurgical Focus — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Dababneh H, Hedna VS, Ford J, Taimeh Z, Peters K, Mocco J, Waters MF Abstract The overall incidence of neurological complications due to infective endocarditis is as high as 40%, with embolic infarcts more common than hemorrhagic strokes. The standard of care for typical strokes does not apply to infective endocarditis because there is a substantial risk of hemorrhage with thrombolysis. In the last decade there have been multiple case reports of intravenous and intraarterial thrombolysis with successful outcomes for acute strokes with related infective endocarditis, but successful endovascular interventions for acute strokes associated with infective endocarditis are rarely reported. To the authors' knowledge, this report is the first case in the literature to use a mechan...

Validation of frontal near-infrared spectroscopy as noninvasive bedside monitoring for regional cerebral blood flow in brain-injured patients.

Neurosurgical Focus — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions The authors demonstrated a linear correlation for frontal NIRS cerebral oxygenation measurements compared with regional CBF on CT perfusion imaging. Thus, frontal NIRS cerebral oxygenation measurement may serve as a useful, noninvasive, bedside intensive care unit monitoring tool to assess brain oxygenation in a direct manner. PMID: 22296679 [PubMed - in process] (Source: Neurosurgical Focus)

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Cerebral blood flow.

Neurosurgical Focus — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Selman WR, Winn HR PMID: 22296680 [PubMed - in process] (Source: Neurosurgical Focus)

Delayed Axillary Artery Pseudoaneurysm as an Isolated Consequence to Anterior Dislocation of the Shoulder

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

We describe a case of delayed axillary artery pseudoaneurysm, presenting as single complication after anterior shoulder dislocation reduction, which was successfully managed by surgical intervention—resection–anastomosis. Although uncommon, pseudoaneurysms should not be forgotten after trivial trauma. The early diagnosis of upper-limb pseudoaneurysms should prevent the risk of vascular and neurological compromises with potential serious long-term sequelae. (Source: Annals of Vascular Surgery)

The invention of an iliosacral screw fixation guide and its preliminary clinical application

Orthopaedic Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: The minimally invasive guide can eliminate discrepancies resulting from the surgeon's own sensory input when inserting screws under the guidance of CT, making percutaneous iliosacral screw fixation more accurate, safe and simple. (Source: Orthopaedic Surgery)

Comparison between anterior and posterior decompression for cervical spondylotic myelopathy: subjective evaluation and cost analysis

Orthopaedic Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Both anterior and posterior decompressions (with instrumentation) are effective procedures for improving the neurological outcomes of patients with CSM. However, although the two approaches have similar health care costs, anterior cervical corpectomy (with instrumentation) seems to be subjectively assessed by patients as better. (Source: Orthopaedic Surgery)

Randomized controlled trial of a new portable calf compression device (Venowave) for prevention of venous thrombosis in high‐risk neurosurgical patients

Journal of Thrombosis and Haemostasis — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Venowave devices are effective in preventing VTE in high‐risk neurosurgical patients. (Source: Journal of Thrombosis and Haemostasis)

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Intracerebroventricular opioids for intractable pain

British Journal of Clinical Pharmacology — Wed, 01 Feb 2012 05:00:00 +0100

SummaryAims: When pain is refractory to systemic opioid and nonopioid analgesic therapy and palliative chemoradiation or ablative or stimulant neurosurgical procedures are not possible, palliative treatment becomes limited, particularly if the patient wishes to be at home at the end of life. Intracerebroventricular (ICV) infusion of morphine in the home setting might be presented as an option. The present article reviews the basic and clinical evidence of the efficacy and safety of ICV administration of opioids. Information was gathered from various bibliographic sources, including PubMed and others, and summarized and evaluated to assess the efficacy and safety of ICV opioids for pain relief. Results from ICV infusion of morphine into terminally‐ill patients refractory to other pain ...

Residency Training Oversight(s) in Surgery: The History and Legacy of the Accreditation Council for Graduate Medical Education Reforms.

The Surgical Clinics of North America — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Nauta RJ Abstract Despite a quarter century of discourse since a sentinel event in New York City raised the question of appropriate oversight for graduate medical education, many questions remain unanswered. Even with the Accreditation Council for Graduate Medical Education rules in place, some opportunity remains to examine handoff methodology, the relationship of duty hours to education, and the impact of fatigue on resident performance. Neurophysiologic adjuncts applied concomitantly to evaluation of didactic performance offer promise for data-driven definition of the optimal shift. Concurrently, the merits of specialty-specific oversight of graduate medical education remain under active consideration. PMID: 22269265 [PubMed - in process] (Source: The Surgical Clini...

Short Term Outcomes after Cardiac Surgery in a Jehovah's Witness Population: An Institutional Experience

Heart, Lung and Circulation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: Cardiac surgery can be performed safely in Jehovah's Witness patients with acceptable outcomes. (Source: Heart, Lung and Circulation)

[Review] Chordoma: current concepts, management, and future directions

The Lancet Oncology — Wed, 01 Feb 2012 05:00:00 +0100

Chordoma is a rare bone cancer that is aggressive, locally invasive, and has a poor prognosis. Chordomas are thought to arise from transformed remnants of notochord and have a predilection for the axial skeleton, with the most common sites being the sacrum, skull base, and spine. The gold standard treatment for chordomas of the mobile spine and sacrum is en-bloc excision with wide margins and postoperative external-beam radiation therapy. Treatment of clival chordomas is unique from other locations with an enhanced emphasis on preservation of neurological function, typified by a general paradigm of maximally safe cytoreductive surgery and advanced radiation delivery techniques. (Source: The Lancet Oncology)

Editorial Board

Clinical Neurology and Neurosurgery — Wed, 01 Feb 2012 04:34:18 +0100

(Source: Clinical Neurology and Neurosurgery)

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Outbreak of Nodding Syndrome SpreadsOutbreak of Nodding Syndrome Spreads

Medscape Today Headlines — Tue, 31 Jan 2012 20:13:43 +0100

The condition has now been seen in South Sudan; CDC recommends ivermectin and antiepileptic therapy, as well as enhanced surveillance. Medscape Medical News (Source: Medscape Today Headlines)

Stem Cell Therapy Promising in Progressive MSStem Cell Therapy Promising in Progressive MS

Medscape Today Headlines — Tue, 31 Jan 2012 19:50:35 +0100

A small proof-of-concept study hints that autologous mesenchymal stem cells may have neuroprotective effects in patients with secondary progressive multiple sclerosis. Medscape Medical News (Source: Medscape Today Headlines)

Neuropathology of neurocutaneous melanosis: histological foci of melanotic neurones and glia may be undetectable on MRI

Acta Neuropathologica — Tue, 31 Jan 2012 16:48:19 +0100

Content Type Journal ArticleCategory CorrespondencePages 1-4DOI 10.1007/s00401-012-0945-0Authors Veronica A. Kinsler, Department of Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Trust, London, UKSimon M. L. Paine, Department of Histopathology, Great Ormond Street Hospital for Children NHS Trust, London, UKGlenn W. Anderson, Department of Histopathology, Great Ormond Street Hospital for Children NHS Trust, London, UKD. Saraji Wijesekara, Department of Neurology, Great Ormond Street Hospital for Children NHS Trust, London, UKNeil J. Sebire, Department of Histopathology, Great Ormond Street Hospital for Children NHS Trust, London, UKWui K. Chong, Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Trust, London, UKWilliam Harkness, Departmen...

Phenotyping of pulmonary carcinoids and a Ki-67-based grading approach

Virchows Archiv — Tue, 31 Jan 2012 16:48:02 +0100

This study indicates that PI in addition to mitotic count may improve prediction of the biological behavior of PC and should be validated in prospective studies. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00428-012-1194-2Authors Tina Zahel, Institute for Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 220/221, 69120 Heidelberg, GermanySabine Krysa, Department of Thoracic Surgery, Thoraxklinik Heidelberg, Heidelberg, GermanyEsther Herpel, Institute for Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 220/221, 69120 Heidelberg, GermanyAlbrecht Stenzinger, Institute for Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 220/221, 69120 Heidelberg, GermanyBenjamin Goeppert, Institute for Pathology, University Hosp...

Brain Tumors in Children- Current Therapies and Newer Directions

Indian Journal of Pediatrics — Tue, 31 Jan 2012 16:47:55 +0100

Abstract Brain tumors are the second most common malignancy and the major cause of cancer related mortality in children. Though significant advances in neuroimaging, neurosurgery, radiation therapy and chemotherapy have evolved over the years, overall survival rate remains less than 75%. Malignant gliomas, high risk medulloblastoma with recurrence and infant brain tumors continue to be a major cause of therapeutic frustration. Even today diffuse pontine gliomas are universally fatal. Though tumors like low grade glioma have an overall excellent survival, recurrences and progression in eloquent areas pose therapeutic challenges. As research continues to unravel the biology including key molecules and signaling pathways responsible for the oncogenesis of different childhood ...

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Incidence and location of positive surgical margins following open, pure laparoscopic, and robotic-assisted radical prostatectomy and its relation with neurovascular preservation: a single-institution experience

Journal of Robotic Surgery — Tue, 31 Jan 2012 16:47:06 +0100

Abstract To evaluate whether robotic-assisted radical prostatectomy (dvRP) provides adequate local control of the disease, incidence of positive surgical margins (PSMs) obtained with dvRP was compared with that of laparoscopic radical prostatectomy (LRP) and with that of open radical retropubic prostatectomy (RRP) performed in a single institution by the same surgeons. We also studied whether neurovascular bundle preservation modified PSM rates. The records were retrospectively reviewed from electronic medical data, and three groups of 100 patients were organized. Group 1 included 100 patients who underwent RRP prior to the incorporation of minimally invasive techniques. Group 2 included the first 100 patients who underwent LRP, and group 3 was made up of th...

Segmentation and quantification of intra-ventricular/cerebral hemorrhage in CT scans by modified distance regularized level set evolution technique

International Journal of Computer Assisted Radiology and Surgery — Tue, 31 Jan 2012 16:47:02 +0100

Conclusions The MDRLSE improved the accuracy and speed for segmentation and calculation of the hemorrhage volume compared to the original DRLSE method. The method generates quantitative information, which is useful for specific decision making and reduces the time needed for the clinicians to localize and segment the hemorrhagic regions. Content Type Journal ArticleCategory Original ArticlePages 1-14DOI 10.1007/s11548-012-0670-0Authors K. N. Bhanu Prakash, Biomedical Imaging Lab, SBIC, Biopolis, Agency for Science, Technology and Research, #07-01, Matrix, 30, Biopolis Road, Singapore, 138671 SingaporeShi Zhou, Biomedical Imaging Lab, SBIC, Biopolis, Agency for Science, Technology and Research, #07-01, Matrix, 30, Biopolis Road, Singapore, 138671 SingaporeTim C. Morg...

Functional knee brace use effect on peak vertical ground reaction forces during drop jump landing

Knee Surgery, Sports Traumatology, Arthroscopy — Tue, 31 Jan 2012 16:46:55 +0100

Conclusions The significantly lower group mean PVGRF while using a FKB could keep traumatic forces from reaching the ACL until the active neuromuscular restraints are activated to provide protection to the knee joint ligaments. Also, accommodation to FKB is possible after approximately 14.0 h of brace use. The results of this paper will assist clinicians in providing information to their patients regarding a FKB ability to offer protection to an ACL-deficient knee or to address concerns about early muscle fatigue, energy expenditure, heart rate, and decrease in performance level. Level of evidence Prospective study, Level I. Content Type Journal ArticleCategory KneePages 1-8DOI 10.1007/s00167-012-1911-zAuthors Neetu Rishiraj, ACTIN Health an...

Grisel’s syndrome: a comprehensive review with focus on pathogenesis, natural history, and current treatment options

Child's Nervous System — Tue, 31 Jan 2012 16:45:16 +0100

Conclusion GS remains a rare, but potentially lethal children condition. Early diagnosis and treatment is crucial to its management and prognosis. Content Type Journal ArticleCategory Review PaperPages 1-5DOI 10.1007/s00381-012-1706-zAuthors Stephen Osiro, Department of Anatomical Sciences, School of Medicine, St. George’s University, Grenada West IndiesKevin J. Tiwari, Department of Anatomical Sciences, School of Medicine, St. George’s University, Grenada West IndiesPetru Matusz, Department of Anatomy, Victor Babes University of Medicine and Pharmacy, Timisoara, RomaniaJerzy Gielecki, Department of Anatomy, Medical School Varmia and Mazuria, Olsztyn, PolandR. Shane Tubbs, Pediatric Neurosurgery, Children’s Hospital, Birmingham, AL, USAMarios Loukas, Department...

The Risks of Blood Transfusion in Patients with Subarachnoid Hemorrhage: Response to Dr. Paul E. Marik

Neurocritical Care — Tue, 31 Jan 2012 07:11:09 +0100

Content Type Journal ArticleCategory Response to Letter to the EditorPages 1-4DOI 10.1007/s12028-012-9674-4Authors Peter Le Roux, Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, PA, USAMichael Diringer, Neurology/Neurosurgery ICU, Washington University, St. Louis, MO, USA Journal Neurocritical CareOnline ISSN 1556-0961Print ISSN 1541-6933 (Source: Neurocritical Care)

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Comparison of Acute Toxicities in Two Primary Chemoradiation Regimens in the Treatment of Advanced Head and Neck Squamous Cell Carcinoma

Annals of Surgical Oncology — Tue, 31 Jan 2012 07:11:02 +0100

Conclusions With concurrent radiotherapy, low-dose, single-agent, weekly cisplatin is less likely than higher-dose daily cisplatin plus 5-fluorouracil provided at the beginning and end of treatment to be associated with ototoxicity. The preliminary data suggest at least equivalent efficacy, but longer follow-up is required. Content Type Journal ArticleCategory Head and Neck OncologyPages 1-8DOI 10.1245/s10434-012-2219-4Authors Katherine Y. Fan, Johns Hopkins University School of Medicine, Baltimore, MD, USAHrishikesh Gogineni, Case Western Reserve University School of Medicine, Cleveland, OH, USADavid Zaboli, Johns Hopkins University School of Medicine, Baltimore, MD, USASpencer Lake, Johns Hopkins University School of Medicine, Baltimore, MD, USAMarianna L. Zahurak...

The pediatric cervical spine instability study

Child's Nervous System — Tue, 31 Jan 2012 07:04:21 +0100

Conclusions There was a low prevalence of cervical instability in this high-risk group. Plain radiographs, flexion–extension radiographs, and CT all had high sensitivities and specificities. MR imaging had a high false-positive rate, making it sensitive but not specific. The data support using either CT or plain radiographs as the initial cervical spine screening study, but CT is recommended because of its superior ability to detect critical injuries. To definitively rule out ligamentous instability after a negative screening CT scan or cervical spine X-ray, these data support using flexion–extension X-rays with fluoroscopy and not MR imaging. Content Type Journal ArticleCategory Original PaperPages 1-7DOI 10.1007/s00381-012-1696-xAuthors Douglas L. Brockmeyer...

Early benefit of preserved cognitive function is not sustained at one-year after cardiac surgery: a longitudinal follow-up of the randomized controlled trial.

Canadian Journal of Anaesthesia — Tue, 31 Jan 2012 05:00:00 +0100

CONCLUSIONS: The short-term preservation of cognitive function in elderly patients using the cell saver management strategy did not translate into a long-term benefit one year after CABG surgery. The presence of progressing cerebrovascular disease may be responsible for the long-term cognitive decline. (ClinicalTrials.gov number, NCT00193999). PMID: 22290354 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)

Left Atrial Myxoma Complicated with an Acute Upper Extremity Embolism.

Annals of Thoracic and Cardiovascular Surgery — Tue, 31 Jan 2012 05:00:00 +0100

Authors: Chiba K, Abe H, Kitanaka Y, Makuuchi H Abstract Atrial myxoma is the most common benign tumor of the heart. Patients who have atrial myxoma usually present with cardiac obstruction, arrhythmia, or peripheral embolization. We encountered an unusual case of acute upper extremity ischemia due to a massive atrial myxoma in a young man. A 38-year-old man was admitted to our hospital with an acute onset of severe, right upper extremity pain and paralysis while working. Neurologic examination yielded normal results, but the patient showed no palpable right radial or ulnar artery. Routine sonographic evaluation revealed acute aortic embolism in his right brachial artery. Because of his young age and otherwise healthy condition, we decided to perform transthoracic echocardiography,...

Hypothalamo-pituitary dysfunction in patients with chronic subdural hematoma.

Physiological Research — Tue, 31 Jan 2012 05:00:00 +0100

Authors: Hána V, Kosák M, Masopust V, Netuka D, Lacinová Z, Kršek M, Marek J, Pecen L Abstract Relatively frequent pituitary hormone deficiencies are observed after traumatic brain injury (TBI) and subarachnoid haemorrhage (SAH) and according to the published studies the neuroendocrine consequenses of traumatic brain injury are underdiagnosed. In a cohort of 59 patients (49 males, mean age 68.3 years, 36-88 years) after evacuation of subdural hematoma (SDH) were evaluated hypothalamo-pituitary functions one week after surgery, after three months and after one year. Hypogonadism was present in 26 % of patients in an acute phase, but in the majority had a transient character. Less than half of patients was GH deficient (GHD) according to the GHRH+arginine test. We did not find an...

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Comparison of computed tomography and magnetic resonance imaging for evaluation of cholesteatoma with labyrinthine fistulae

The Laryngoscope — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions:SIR was more strongly correlated than CT findings to the clinical status of patients with labyrinthine fistulae caused by cholesteatoma. Adhesion of the cholesteatoma matrix to the membranous labyrinth correlated with the SIR; thus, SIR may accurately reflect the extent of inner ear dysfunction with a labyrinthine fistula. (Source: The Laryngoscope)

Effect of a fluid challenge on the Surgical Pleth Index during stable propofol–remifentanil anaesthesia

Acta Anaesthesiologica Scandinavica — Tue, 31 Jan 2012 05:00:00 +0100

ConclusionsDuring stable anaesthesia and surgery, SPI may change in response to FC. The effect of FC on SPI is influenced by volaemia and CePPF through pulse wave amplitude modifications. These situations may confound the interpretation of SPI as a surrogate measure of the nociception–anti‐nociception balance. (Source: Acta Anaesthesiologica Scandinavica)

Fatal hemorrhagic infarction of posterior fossa meningioma during cardiopulmonary bypass.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:18:22 +0100

Authors: Sun H, Ross DA Abstract Few publications address cardiac surgery in the presence of meningioma. Individual complications include transient visual loss from a suprasellar meningioma, hemiparesis after mitral valve replacement with recovery after resection, and non-fatal hemorrhage into a posterior fossa meningioma. The largest report of 16 patients with known meningiomas over 11 years suggested a benign course, with no new neurologic symptoms and no required resection of a meningioma over an average follow-up of 31 months. In 2 cases we report a presumed posterior fossa meningioma led to fatal outcome after cardiac surgery performed on bypass. Possible causes and future considerations are discussed. PMID: 22269734 [PubMed - in process] (Source: The Annals of Thoracic Su...

Primitive neuroectodermal tumor of the heart.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:13:24 +0100

We present a case of primitive neuroectodermal tumor of the left atrium with involvement of the coronary sinus. The initial presentation was of cardiac tamponade resulting from the size of the tumor. There was no evidence of tumor elsewhere, and after complete resection and without adjuvant chemotherapy the patient is well at 2-year follow-up. There has been no evidence of tumor recurrence. This is a rare reported case of resection of a cardiac primitive neuroectodermal tumor without adjuvant chemotherapy. Other cases in the literature have been treated by orthoptic transplantation and resection with chemotherapy. PMID: 22269764 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Transcranial MRI-guided Focused UltrasoundTranscranial MRI-guided Focused Ultrasound

Medscape Today Headlines — Tue, 31 Jan 2012 04:00:00 +0100

The authors present transcranial MRI-guided focused ultrasound as a noninvasive, precise, and radiation-free neurosurgical technique for the treatment of neuropathic pain. Neurosurgical Focus (Source: Medscape Today Headlines)

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Unusual Resolution of a Depressed Skull Fracture following Repeat Head Trauma: The Two-Hit Hypothesis

Pediatric Neurosurgery — Mon, 30 Jan 2012 23:00:00 +0100

Pediatr Neurosurg 2011;47:230–232 (DOI:10.1159/000334279) (Source: Pediatric Neurosurgery)

Primary Pediatric Skull Tumors

Pediatric Neurosurgery — Mon, 30 Jan 2012 23:00:00 +0100

Pediatr Neurosurg 2011;47:198–203 (DOI:10.1159/000330544) (Source: Pediatric Neurosurgery)

Peculiarities in Cases of Spina Bifida Cystica Managed Recently in South-East Nigeria: Could Antimalarial Drugs Be a Major but Unrecognized Etiologic Factor

Pediatric Neurosurgery — Mon, 30 Jan 2012 23:00:00 +0100

Pediatr Neurosurg 2011;47:194–197 (DOI:10.1159/000334255) (Source: Pediatric Neurosurgery)

Unusual Resolution of a Depressed Skull Fracture following Repeat Head Trauma: The Two-Hit Hypothesis?

Pediatric Neurosurgery — Mon, 30 Jan 2012 23:00:00 +0100

Pediatr Neurosurg 2011;47:230–232 (DOI:10.1159/000334279) (Source: Pediatric Neurosurgery)

New Clinical Trial Network for Neurology LaunchedNew Clinical Trial Network for Neurology Launched

Medscape Today Headlines — Mon, 30 Jan 2012 22:57:30 +0100

NeuroNEXT will cover 400 brain diseases and offer a centralized institutional review board to help trials move faster. Medscape Medical News (Source: Medscape Today Headlines)

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Effects of Early TBI May Linger 10 Years LaterEffects of Early TBI May Linger 10 Years Later

Medscape Today Headlines — Mon, 30 Jan 2012 17:31:47 +0100

Problems persist after severe early childhood traumatic brain injury; young children may not be more resilient to the cognitive effects of traumatic brain injury. Medscape Medical News (Source: Medscape Today Headlines)

Cyberknife Radiation Successful For Treating Tigeminal Neuralgia

Health News from Medical News Today — Mon, 30 Jan 2012 17:00:00 +0100

A small study published online in the Journal of NeuroInterventional Surgery shows that a technique in which highly concentrated beams of radiation are used, known as Cyberknife, can relieve the stabbing pain of the facial nerve condition trigeminal neuralgia. About five in every 100,000 individuals is thought to suffer from trigeminal neuralgia, which is characterized as a sharp, stabbing/burning sensation in the jaw or cheek. The name originates from the trigeminal nerve, the source of the pain... (Source: Health News from Medical News Today)

Spinal cord herniation: Management and outcome in a series of 12 consecutives patients and review of the literature

Acta Neurochirurgica — Mon, 30 Jan 2012 16:06:08 +0100

Conclusions The authors present one of the largest studies to date regarding patients with spinal cord herniation and emphasize that the possibility of this condition must be kept in mind when addressing all patients with progressive myelopathy. Content Type Journal ArticleCategory Clinical ArticlePages 1-8DOI 10.1007/s00701-011-1265-1Authors Francesco Prada, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, via Celoria 11, 20133 Milan, ItalyAndrea Saladino, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, via Celoria 11, 20133 Milan, ItalySergio Giombini, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, via Celoria 11, 20133 Milan, ItalyAlessandra Erbetta, Department of Neuroradiology, F...

Patient Care Could Be Revolutionized By Diagnostic Brain Tumor Test

Health News from Medical News Today — Mon, 30 Jan 2012 08:00:00 +0100

Researchers at UT Southwestern Medical Center have developed what they believe to be the first clinical application of a new imaging technique to diagnose brain tumors. The unique test could preclude the need for surgery in patients whose tumors are located in areas of the brain too dangerous to biopsy. This new magnetic resonance spectroscopy (MRS) technique provides a definitive diagnosis of cancer based on imaging of a protein associated with a mutated gene found in 80 percent of low- and intermediate-grade gliomas. Presence of the mutation also means a better prognosis... (Source: Health News from Medical News Today)

Care and support needs of patients and carers early post-discharge following treatment for non-malignant brain tumour: establishing a new reality

Supportive Care in Cancer — Mon, 30 Jan 2012 06:32:03 +0100

Conclusion Participants had a tendency to rely on informal support networks but identified unmet information and support needs particularly for carers. These findings highlight the need for more efficient and effective discharge preparation, referral to services and supports, provision of timely information and support for family caregivers of those with brain tumour. Content Type Journal ArticleCategory Original ArticlePages 1-16DOI 10.1007/s00520-012-1383-1Authors Petrea Cornwell, Metro North Health Service District, Queensland Health, Chermside, AustraliaBronwyn Dicks, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, AustraliaJennifer Fleming, School of Health and Rehabilitation Sciences, The University of Queensland, St. Luc...

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Neuroprotective Effects of NKN on Focal Cerebral Ischemia in Rats.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: The results implied NKN could protect brain against injury caused by cerebral ischemia. PMID: 22274963 [PubMed - in process] (Source: Turkish Neurosurgery)

The role of folic Acid in prevention of neural tube defects caused by high dose progesterone.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: Exogenous progesterone at levels twenty times above its physiologic range in chick embryos causes NTDs. FA supplementation decreases the frequency of NTDs but does not abolish them. PMID: 22274964 [PubMed - in process] (Source: Turkish Neurosurgery)

Modifying the Details of Aspiration Operation may Contribute to the Improvement of Prognosis of Patients with ICH.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: Our data suggested that modifying details of aspiration operation may contribute to the improved prognosis of ICH patients. PMID: 22274965 [PubMed - in process] (Source: Turkish Neurosurgery)

Lumbar peritoneal shunt in idiopathic intracranial hypertension.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: LP shunt is safe and effective in IIH. Results in terms of improvement in vision were better in good pre operatively vision group. PMID: 22274966 [PubMed - in process] (Source: Turkish Neurosurgery)

Analysis of scalp wound infections among craniocerebral trauma patients following the 2008 wenchuan earthquake.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: The rate of scalp wound infections following earthquake-induced craniocerebral trauma, which was dominated by Grampositive Staphylococcus aureus infection, has been markedly elevated in recent years. Early debridement and suturing, nutritional support and application of sensitive antibiotics can augment the therapeutic effect. PMID: 22274967 [PubMed - in process] (Source: Turkish Neurosurgery)

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Surgical Treatment of Primary Trigeminal Neuralgia: Comparison of the Effectiveness Between MVD and MVD+PSR in a Series of 210 Patients.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: MVD+PSR was obviously superior to MVD in completely eliminating pain in short-term period after operation, however, longer pain-free rate need even longer time to follow up. Identifying the responsible vascular exactly and handling it reasonably were key to both groups. PMID: 22274968 [PubMed - in process] (Source: Turkish Neurosurgery)

Extradural haematoma in children: surgical experiences and prospective analysis of 170 cases.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: EDH is recognized as one of the most rewarding neurosurgical emergencies. It must be diagnosed in the early period of the trauma and evacuated early to prevent potential mortality and morbidity. Different factors affect the outcome of extradural haematoma Surgery including age of the patient, presence of cranial fractures, associated brain lesions and pre-operative neurological condition of patient, duration of time interval between onset of coma and surgical intervention. Better prognosis is seen in patients less than 10 years of age. PMID: 22274969 [PubMed - in process] (Source: Turkish Neurosurgery)

Temporary clamping of external carotid artery in convexity, parasagittal and temporal base meningioma.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: Temporary clamping of external carotid artery is a safe, simple and cost-effective alternative to embolization for the surgery of large meningiomas. This can be practiced at all the centers. PMID: 22274970 [PubMed - in process] (Source: Turkish Neurosurgery)

Surgical treatment of the spinal stenosis with an interspinous distraction device: do we really restore the foraminal height?

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: Using the Coflex device is a minimal invasive, effective and safe procedure. Restoration of the foraminal height may not be a responsible factor for clinical improvement. We think microsurgical decompression looks responsible of the good clinical outcome and using interspinous device is unnecessary. Comparative clinical studies can be informative. PMID: 22274971 [PubMed - in process] (Source: Turkish Neurosurgery)

The results of radiological screening in asymptomatic at-risk members of intracranial aneurysm families from the Turkish population.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: Our results support a general recommendation to screen first-degree relatives of IA patients from families with two or more cases of IA. Familial aggregation of IA's is not only useful in identifying asymptomatic individuals harboring unruptured aneurysms but also implicates a genetic contribution to the pathogenesis of this disease in different patient populations. PMID: 22274972 [PubMed - in process] (Source: Turkish Neurosurgery)

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Variations of the superficial peroneal nerve and its terminal branches in the Turkish newborn fetuses.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: The course of SPN on the anterolateral surface of the leg and its terminal branches on the dorsal surface of the foot were quite different. This unusual variant location will enable the surgeon to find and preserve the SPN and its terminal branches. PMID: 22274973 [PubMed - in process] (Source: Turkish Neurosurgery)

Endoscopic Endonasal Transsphenoidal Exposure of Circle of Willis (Cw); Can It be Applied in Vascular Neurosurgery in the Near Future? A Cadaveric Study of 26 Cases.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: Endoscopic endonasal extended transsphenoidal exposure of CW can make the surgeon more efficient in removing midline skullbase lesions with safe handling of different parts of circle of Willis and it may help in development of endonasal endoscopic vascular neurosurgery in the near future. PMID: 22274974 [PubMed - in process] (Source: Turkish Neurosurgery)

The effects of diesel exhaust particles on neural tube development in the early stage chicken embryo.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: Thus, the direct neurotoxic effects of DEP, which the whole population encounters inevitably, have been shown in the early stages of embryonic development. Further studies are needed to identify the effects of these particles in the later stages of embryonic development. PMID: 22274975 [PubMed - in process] (Source: Turkish Neurosurgery)

The Effect of KinesioTape Application on Functional Performance in Surgeons Who have Musculo-Skeletal Pain after Performing Surgery.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: Findings demonstrated that Kinesio taping would be an effective method for reducing neck and low back pain and improving functional performance. PMID: 22274976 [PubMed - in process] (Source: Turkish Neurosurgery)

A case of primary diffuse leptomeningeal gliomatosis predominantly involving the cervical spinal cord and mimicking chronic meningitis.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

Authors: Heijink DS, Urgun K, Sav A, Seker A, Konya D Abstract Gliomas may rarely arise in the leptomeninges without any evidence of intraaxial involvement. A case of primary diffuse leptomeningeal gliomatosis (PDLG) histologically diagnosed as oligoastrocytoma is presented. A 50-year-old woman presented with nausea, vomiting and headache. Magnetic resonance imaging (MRI) of cranium and cervical region revealed dural thickening starting from the craniocervical junction to the level of C4 without any parenchymal lesions. CSF examination showed an increase in protein and decrease in glucose levels. There were neither any kind of atypical cells nor any kind of growth in bacterial cultures. The patient underwent biopsy at the level of C1 for diagnosis. The specimen wa...

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Plasmocytoma of the skull vault.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: Although the prognosis of a plasmocytoma is relatively good, this study demonstrated that patients with ventral frontal cortex tumour may have significantly worse mood pre- or postoperatively. Clinicians should therefore be careful in the follow-up period. PMID: 22274978 [PubMed - in process] (Source: Turkish Neurosurgery)

Cerebral contusion as a rare cause of foot drop: case report.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

Authors: Oktem NB, Tari R, Kotil K, Bilge T Abstract A 74-year-old woman, taking anticoagulant therapy for chronic heart failure, presented to our emergency room with left dorsiflexion weakness 8 hours from after multitrauma. A detailed neurological examination revealed only 0/5 strength in the left foot dorsiflexion without any upper motor neuron signs. While there was no spinal cord pathology detected, cranial computed tomography demonstrated a lesion in the right parasagittal localization consistent with hemorrhagic contusion. Clinical follow-ups showed an improvement in neurological findings with muscle power of 3/5 in day 5 and 5/5 in day 45 of admission. The parasagittal region has a foot localization in the homonculus and lesions in this area can rarely pre...

Does ventricular opening promote remote cerebellar haemorrhage?

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

Authors: Ziyal I, Bilginer B, Yavuz K, Turk C, Ozgur C, Benli K Abstract Cerebellar haemorrhage after supratentorial craniotomy is a rare complication Because of its significant morbidity and mortality rates, being aware of this complication is important for early diagnosis. In a 30-year-old male with multiple intracranial cavernomas, remote cerebellar haemorrhage (RCH) was observed after removal of symptomatic left temporal lesion. The lateral wall of the temporal horn that was tightly attached to the cavernoma was also opened and excessive drainage of the CSF occurred. The haemorrhage is attributed to opening of the ventricle wall and excessive drainage of cerebrospinal fluid (CSF) during the procedure. PMID: 22274980 [PubMed - in process] (Source: Turkish Neu...

Aneurysmal bone cyst of clivus and c1 c2: case report and review of literature.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

We report a case of aneurysmal bone cyst of clivus C1 and C2 with minimum symptoms. Involvement of C1 and clivus separately had been reported in past, but simultaneous involvement of both is presented in this report for the very first time. PMID: 22274981 [PubMed - in process] (Source: Turkish Neurosurgery)

Characterization of an intracranial neurothekeoma: case report.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

CONCLUSION: Neurothekeomas, also known as nerve sheath myxomas, are rare benign tumors. There have been two previous cases reported with an intracranial location. The information presented here now represents the third such case in the literature. PMID: 22274982 [PubMed - in process] (Source: Turkish Neurosurgery)

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Angiosarcoma of skull in a pregnant woman: case report and review of the literature.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

Authors: Samadian M, Rakhshan M, Haddadian K, Rezaei O, Zamani S, Khormaee F Abstract Angiosarcoma is a rare tumor of bone that uncommonly involves the skull. Primary neoplasms of the skull represent 2.6% of primary neoplasms of bone. We wish to report a case of angiosarcoma of he skull in an 18-year-old pregnant woman who presented with a rapidly growing left frontotemporal mass. Neuroimaging revealed a left frontotemporal mass with destruction of diploic space and both tables and with extension to the subgaleal and epidural spaces. The patient underwent surgery and the tumor was removed totally. Histological features of angiosarcoma were seen in the pathology study. She received adjuvant chemotherapy and radiation therapy. She has remained well during 6 years of f...

Cerebral Abscesses in Behcet's Disease: A Case Report.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

Authors: Tokgoz S, Ogmegul A, Mutluer M, Kivrak AS, Ustun ME Abstract Behçet's disease is a multisystem relapsing inflammatory disorder of unknown cause. Neurological involvement is one of the most serious causes of long-term morbidity and mortality in Behçet's disease. Cerebral abscess is very rare in literature. A 45-yr-old man with Behçet's disease manifesting focal epileptic seizure and multiple cerebral abscesses is reported in the case. He was diagnosed with cerebral abscess and was treated with antibiotics but no improvement occurred. Excisional biopsy was performed and the lesions were consistent with abscess. The clinical state of the patient gradually improved. The patient had no further complications. The etiology, and clinical and magnetic resonance...

Chronic subdural hematoma after endoscopic third ventriculostomy: a case report and literature review.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

Authors: Tekin T, Colak A, Kutlay M, Demircan MN Abstract Chronic subdural hematoma is a very rarely observed complication after endoscopic third ventriculostomy (ETV). A 21-year-old male patient was admitted to our clinic with complaining of headache, weakness and tremor. The fundoscopic examination revealed slightly indistinct border of the papilla and neurological examination findings were normal. The cranial computed tomographic (CT) and magnetic resonance imaging (MRI) findings demonstrated three-ventricular hydrocephalus due to aqueductal stenosis and ETV was performed. The symptoms got better after the operation. At 1½ month postoperatively the patient reapplied to our clinic with a symptom of severe headache. Cranial BT imaging demonstrated enlargement of...

Endoscopic management of a lower clival chondroid chordoma: case report.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

We report herein a case of lower clival chondroid chordoma, focusing on the surgical procedure of endoscopic endonasal surgery. A 36-yearold woman presented with progressive headache, right shoulder pain, and right hypoglossal nerve palsy. Computed tomography (CT) and magnetic resonance (MR) imaging revealed an extradural tumor located in the lower clivus, including the anterior aspect of the foramen magnum, deeply compressing the medulla and upper cervical spinal cord. Endoscopic endonasal surgery was performed via two nostrils. Since the basiocciput was destroyed by the tumor, removal of the tumor allowed identification of the middle clivus superiorly, the anterior arch of the atlas inferiorly, and anteromedial parts of occipital condyles bilaterally without drilling ...

Ossifying Pituitary Adenoma Co-existing with Astrocytoma and Pituitary Adenoma Associated with Gangliocytoma: Two Unusual Conditions.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

Authors: Jaiswal S, Vij M, Jaiswal AK, Chand G, Behari S, Kumarjain V Abstract Bone formation in pituitary adenoma is an extremely rare finding. Only five previous cases have been published. This is the sixth case report of an ossifying pituitary adenoma and the first case report of a pituitary adenoma with bone formation coexisting with WHO grade II astrocytoma. MRI imaging revealed an unusual eggshell cap-like calcified structure surrounding the tumor. Histologically, the adenoma contained irregularly anastomosing trabeculae with well-formed lacunae and osteoblasts along the margins. Our second case concerns a 25-year-old male patient who presented with complains of off and on headache for 12 months. MRI (head) revealed a 4x3cm well defined rounded lesion in the ...

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Acute feedback control of astrocytic glycolysis by lactate

Glia — Mon, 30 Jan 2012 05:00:00 +0100

AbstractNeuronal activity is accompanied by a rapid increase in interstitial lactate, which is hypothesized to serve as a fuel for neurons and a signal for local vasodilation. Using FRET microscopy, we report here that the rate of glycolysis in cultured mice astrocytes can be acutely modulated by physiological changes in extracellular lactate. Glycolytic inhibition by lactate was not accompanied by detectable variations in intracellular pH or intracellular ATP and was not dependent of mitochondrial function. Pyruvate was also inhibitory, suggesting that the effect of lactate is not mediated by the NADH/NAD+ ratio. We propose that lactate serves as a fast negative feedback signal limiting its own production by astrocytes and therefore the amplitude of the lactate surge. The inhibition of gl...

A randomized trial of decision-making in asymptomatic carotid stenosis

Neurology — Mon, 30 Jan 2012 05:00:00 +0100

Conclusions: Presentation format (information framing) strongly determines patient decision-making in asymptomatic carotid stenosis. Subject age, gender, and education level may also influence the decision. Clinicians should consider the influence of these variables when counseling patients. (Source: Neurology)

Serotonin protects mouse liver from cholestatic injury by decreasing bile salt pool after bile duct ligation

Hepatology — Mon, 30 Jan 2012 05:00:00 +0100

Conclusion: We propose a physiological function of serotonin is to ameliorate liver injury and stabilize the bile salt pool through adaptation of renal transporters in cholestatis. (HEPATOLOGY 2012.) (Source: Hepatology)

The usefulness of neuronavigation in functional hemispherectomy

Journal of Epilepsy and Clinical Neurophysiology — Mon, 30 Jan 2012 02:48:25 +0100

We report two cases of 5-year-old girls. The first one had a diagnosis of Rasmussens syndrome. The second one had a large porencephalic cyst secondary to perinatal cerebral ischemia. Despite trials of anticonvulsants, both patients deteriorated, and a functional hemispherectomy guided by neuronavigation was indicated and performed, with low morbidity and excellent seizure control. The neuronavigation proved to be a valuable guidance tool in performing the functional hemispherectomy, making the disconnections more accurate, and thus decreasing the surgical time and blood loss.Aplicabilidade da neuronavegação em hemisferectomia funcional As encefalopatias epilépticas catastróficas da infância compreendem condições graves que associam disfunção cerebral e crises epilépticas refrat...

What is the Mnemonic for the Elbow Ossification Centers?

PediatricEducation.org — Mon, 30 Jan 2012 00:11:02 +0100

Discussion Injuries to the pediatric elbow are difficult to diagnose because of the anatomy and normal growth and ossification of the elbow. Swelling, tenderness, ecchymosis, with or without deformity are common signs of fracture. Physical examination should include a careful neurovascular examination for distal pulses and capillary refill, paresthesias, increased pain with movement distal to the elbow or paralysis of the hand muscles as any of these may indicate compartment syndrome. Common radiographs obtained are AP and lateral plain radiographs. Oblique films and comparison films of the contralateral elbow are also often needed to distinguish between a fracture and normal growth plate. The alignment of the anterior humerus line and the fat pads should be reviewed as misalignment may ...

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Front & Back Matter

Pediatric Neurosurgery — Sun, 29 Jan 2012 23:00:00 +0100

Pediatr Neurosurg 2011;47:X (DOI:10.1159/000336860) (Source: Pediatric Neurosurgery)

Neuropathy Dermatitis following Surgical Nerve Injury

Advances in Pharmacological Sciences — Sun, 29 Jan 2012 18:41:46 +0100

Conclusions. Neuropathy dermatitis is apparently a new variant of dermatitis that follows nerve cut during surgery. (Source: Advances in Pharmacological Sciences)

Methylation status of O6-methylguanine-DNA-methyl transferase promoter region in non-small-cell lung cancer patients with brain metastasis

Clinical and Translational Oncology — Sat, 28 Jan 2012 16:53:10 +0100

Conclusions NSCLC patients with brain metastasis treated by brain surgery followed by radiotherapy may have a higher chance of relapse when the tumour has methylation of the MGMT promoter region. Content Type Journal ArticleCategory Research ArticlesPages 31-35DOI 10.1007/s12094-012-0758-6Authors Kenji Hashimoto, Neurosurgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 JapanYoshitaka Narita, Neurosurgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 JapanYuko Matsushita, Neurosurgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 JapanYasuji Miyakita, Neurosurgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 JapanMakoto...

μMLC-LINAC radiosurgery for intracranial meningiomas of complex shape

Acta Neurochirurgica — Sat, 28 Jan 2012 16:50:58 +0100

Conclusions LINAC radiosurgery using a micro multi-leaf collimator for complex shaped intracranial meningiomas is effective yielding a high local tumor control, whereas the treatment-related morbidity remains low. Content Type Journal ArticleCategory Clinical ArticlePages 1-6DOI 10.1007/s00701-012-1278-4Authors Faycal El Majdoub, Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, GermanyMoataz Elawady, Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, GermanyChristian Bührle, Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, GermanyMustapha El-Khatib, Dep...

15. Intraoperative monitoring of evoked potentials in scoliosis surgery at University Hospital Brno

Clinical Neurophysiology — Sat, 28 Jan 2012 16:42:18 +0100

Aim: The aim of our study was the evaluation of sensitivity and specificity of intraoperative monitoring (IOM) of evoked potentials (EP) in scoliosis and developmental spinal deformities surgery in our hospital. (Source: Clinical Neurophysiology)

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14. Electrophysiological intraoperative monitoring in vestibular schwannoma surgery

Clinical Neurophysiology — Sat, 28 Jan 2012 16:42:18 +0100

We present the results of 48 patients, who underwent surgery of vestibular schwannomas (VS) from 2001 to 2011, with electrophysiological monitoring. Material and methods: Fifty operations (two re-resection). Monitoring used: EMG in identification and monitoring of CN VII, auditory evoked potentials (BAEP, ABR), motor evoked potentials (MEP). House–Brackmann scale (HB) was used in evaluation of postoperative deficit of CN VII. To determine the hearing disability we used audiometry or AAO-HNS score. We detected preoperative anacusis (respectively D score in the AAO-HNS classification) by 82% of patiens. (Source: Clinical Neurophysiology)

Training in laparoscopic colorectal surgery: a new educational model using specially embalmed human anatomical specimen

Surgical Endoscopy — Sat, 28 Jan 2012 06:43:05 +0100

Conclusion The new training model for laparoscopic colorectal surgery proved to be a high-quality tool, concentrating on laparoscopic colorectal anatomy in a skills training setting. We believe it may be a valuable adjunct to residency training programs based on the principle of “training before the job.” Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-012-2158-yAuthors Juliette C. Slieker, Department of Surgery, Erasmus University Medical Center, Rotterdam, The NetherlandsHilco P. Theeuwes, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The NetherlandsGöran L. van Rooijen, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The NetherlandsJohan F. Lange, Department of Surgery, E...

Intraoperative MRI and endocrinological outcome of transsphenoidal surgery for non-functioning pituitary adenoma

Acta Neurochirurgica — Fri, 27 Jan 2012 17:56:15 +0100

Conclusion The use of iMRI in transsphenoidal surgery for non-functioning pituitary adenoma might lead to higher total resection rates. In our series, resection of remnants detected by iMRI was neither associated with higher incidences of postoperative hypopituitarism nor with lower recovery rates of pituitary axes. Content Type Journal ArticleCategory Clinical ArticlePages 1-9DOI 10.1007/s00701-012-1285-5Authors Sven Berkmann, Department of Neurosurgery, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, SwitzerlandJavier Fandino, Department of Neurosurgery, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, SwitzerlandBeat Müller, Medical University Clinic, Kantonsspital Aarau, Aarau, SwitzerlandLuca Remonda, Division of Neuroradiology, Department of Radiology, Kantonsspit...

Hematogenous extraneural metastasis of the germinomatous component of a pineal mixed germ cell tumor

Brain Tumor Pathology — Fri, 27 Jan 2012 17:56:01 +0100

Abstract A 23-year-old man presented with a mass in the pineal region and obstructive hydrocephalus. A neuroendoscopic biopsy for the lesion, ventriculoperitoneal (VP) shunting, and focal irradiation were conducted as initial treatment. Histological diagnosis of the biopsy specimen was germinoma. He underwent further irradiation and two tumor resections. Histological diagnosis was mature teratoma without a germinomatous component. After serial treatments, the intracranial lesion was controlled. However, 14 months after presentation, extraneural lesions were confirmed in the posterior mediastinum and retroperitoneal space. The biopsy specimen of the retroperitoneal space lesion was histologically diagnosed as germinoma. Although chemotherapy with cisplatin and etoposid...

Cerebellar toxoplasmosis in HIV/AIDS infant: case report and review of the literature

Neurological Sciences — Fri, 27 Jan 2012 17:55:44 +0100

Abstract Cerebellar mass lesion is an uncommon presentation of toxoplasmosis. The authors report one rare case in an 11-month-old HIV/AIDS female infant who presented with deterioration in her developmental milestones. CT scan revealed a ring-enhancing mass lesion in the right cerebellar hemisphere with secondary obstructive hydrocephalus. A ventriculoperitoneal shunt was inserted prior to posterior fossa decompression and biopsy of the lesion. The specimens obtained were divided into two. One specimen was sent for histological diagnosis immediately after surgery while the second specimen was preserved until the release of the histology report. The initial histopathology report indicated a neoplastic process. Immunohistochemical stains were attempted but interpreted with d...

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An adolescent with suspected intracranial hypertension—ALL is not what it seems

Child's Nervous System — Fri, 27 Jan 2012 17:55:33 +0100

Content Type Journal ArticleCategory Case ReportPages 1-6DOI 10.1007/s00381-012-1697-9Authors Asgeir Store Jakola, Department of Neurosurgery, St. Olavs University Hospital, 7006 Trondheim, NorwaySasha Gulati, Department of Neurosurgery, St. Olavs University Hospital, 7006 Trondheim, Norway Journal Child's Nervous SystemOnline ISSN 1433-0350Print ISSN 0256-7040 (Source: Child's Nervous System)

Intra-operative 3-T MRI for paediatric brain tumours: challenges and perspectives

Pediatric Radiology — Fri, 27 Jan 2012 17:54:47 +0100

Abstract MRI is the ideal modality for imaging intracranial tumours. Intraoperative MRI (ioMRI) makes it possible to obtain scans during a neurosurgical operation that can aid complete macroscopic tumour resection — a major prognostic factor in the majority of brain tumours in children. Intra-operative MRI can also help limit damage to normal brain tissue. It therefore has the potential to improve the survival of children with brain tumours and to minimise morbidity, including neurological deficits. The use of ioMRI is also likely to reduce the need for second look surgery, and may reduce the need for chemotherapy and radiotherapy. High-field MRI systems provide better anatomical information and also enable effective utilisation of advanced MRI techniques such as perfusi...

Osteochondral transplantation using autografts from the upper tibio-fibular joint for the treatment of knee cartilage lesions

Knee Surgery, Sports Traumatology, Arthroscopy — Fri, 27 Jan 2012 17:53:00 +0100

Conclusions This work corroborates that mosaicplasty technique using autologous osteochondral graft from the upper tibio-fibular joint is effective to treat osteochondral defects in the knee joint. No relevant complications related to donor zone were registered. Level of evidence Case series, Level IV. Content Type Journal ArticleCategory KneePages 1-7DOI 10.1007/s00167-012-1910-0Authors João Espregueira-Mendes, Saúde Atlântica Sports Center–F.C. Porto Stadium, Minho University and Porto University, Porto, PortugalHélder Pereira, Saúde Atlântica Sports Center–F.C. Porto Stadium, Minho University and Porto University, Porto, PortugalNuno Sevivas, Saúde Atlântica Sports Center–F.C. Porto Stadium, Minho University and Porto University, Po...

What's Hot at International Stroke Conference 2012?What's Hot at International Stroke Conference 2012?

Medscape Today Headlines — Fri, 27 Jan 2012 17:30:39 +0100

Anticipated data include findings from the SWIFT, SPS3, TREVO and WARCEF trials, and more from SAMMPRIS. Medscape Medical News (Source: Medscape Today Headlines)

Penicillin and Multiple Sclerosis: What's the Connection?Penicillin and Multiple Sclerosis: What's the Connection?

Medscape Today Headlines — Fri, 27 Jan 2012 16:23:23 +0100

Trying to confirm previous data about an etiologic association with MS, investigators find surprising results. Medscape Neurology (Source: Medscape Today Headlines)

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Laparoscopic resection of a retroperitoneal schwannoma

Asian Journal of Endoscopic Surgery — Fri, 27 Jan 2012 11:25:39 +0100

AbstractHerein is a report of a case of a 34‐year‐old man whose chief complaint was right lower abdominal pain. He was diagnosed with acute appendicitis. Additionally, an abdominal CT scan found retroperitoneal tumor approximately 5 cm in size, with an imaging effect, located adjacent to the dorsal side of the inferior vena cava. For this suspected neurogenic tumor, laparoscopic appendectomy and retroperitoneal tumorectomy were performed after conservative treatment of appendicitis. The retroperitoneal tumor was 5.5 × 3.5 cm in size, had a capsule, smooth surface and soft elasticity, and the divided face was solid white. The histopathological work‐up revealed that the tumor was a benign mixed‐type schwannoma, in which spindle cells were arranged. The patient's postoperativ...

Residency Training Oversight(s) in Surgery: The History and Legacy of the Accreditation Council for Graduate Medical Education Reforms

Surgical Clinics of North America — Fri, 27 Jan 2012 11:25:19 +0100

Despite a quarter century of discourse since a sentinel event in New York City raised the question of appropriate oversight for graduate medical education, many questions remain unanswered. Even with the Accreditation Council for Graduate Medical Education rules in place, some opportunity remains to examine handoff methodology, the relationship of duty hours to education, and the impact of fatigue on resident performance. Neurophysiologic adjuncts applied concomitantly to evaluation of didactic performance offer promise for data-driven definition of the optimal shift. Concurrently, the merits of specialty-specific oversight of graduate medical education remain under active consideration. (Source: Surgical Clinics of North America)

Anatomic Distribution of Stroke and Its Relationship to Perioperative Mortality and Neurologic Outcome Following TEVAR

Journal of Vascular Surgery — Fri, 27 Jan 2012 11:25:16 +0100

To assess the anatomic distribution of stroke after TEVAR and its relationship to perioperative mortality and neurologic outcome. A retrospective review was performed for patients undergoing TEVAR between 2001 and 2010. Aortic arch hybrid and abdominal debranching cases were excluded. Demographics, operative variables, and neurologic complications were examined. Stroke was defined as any new focal or global neurologic deficit with radiographic confirmation of cerebral infarction. (Source: Journal of Vascular Surgery)

Prospective Neurocognitive Evaluation of Patients Undergoing Carotid Interventions

Journal of Vascular Surgery — Fri, 27 Jan 2012 11:25:16 +0100

During carotid interventions there is a risk of distal cerebral embolization. Here we prospectively investigate whether subclinical microembolization seen on postoperative MRI leads to cognitive deficits in a cohort of patients undergoing carotid endarterectomy (CEA) or carotid artery stenting (CAS). (Source: Journal of Vascular Surgery)