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Clinical Neurology and Neurosurgery

Ilaria Paolasso, Chiara Cambise, Daniele Coraci, Filippo M Del Tedesco, Carmen Erra, Eduardo Fernandez, Luca Padua
Ultrasound is helpful to identify nerve suffering cause. We report a case of pain at leg associated with burning paresthesia. Ultrasound found tibialis muscle herniation, close to superficial fibular nerve. The morphological alteration was supposed to be the cause of symptoms. Neurolysis, based on ultrasonographic findings, allowed symptoms relief.
October 6, 2016: Clinical Neurology and Neurosurgery
Manish K Kasliwal, Christopher D Witiw, Vincent C Traynelis
OBJECTIVES: A common question posed by patients undergoing cervical fusion pertains to the likelihood of perceiving a postoperative limitation in neck mobility. The aim of this study was to assess the change in neck mobility after subaxial cervical fusion using an objective range of motion (ROM) measure and patient reported assessment. PATIENTS AND METHODS: Patients older than 18 years of age, undergoing first-time anterior or posterior subaxial cervical arthrodesis for a symptomatic spondylotic process (radiculopathy, cervical spondylotic myelopathy or primary neck pain) at a single center were eligible...
October 1, 2016: Clinical Neurology and Neurosurgery
Tyler J Uppstrom, Ranjodh Singh, Georgios F Hadjigeorgiou, Rajiv Magge, Rohan Ramakrishna
The importance of surgery and maximal extent of resection (EOR) is well established in primary low-grade glioma (LGG) management. However, the role of surgery in the management of recurrent LGG is less clear. A recent review on the management of recurrent LGG concluded there was insufficient evidence to recommend surgery. Here, we summarize the recent advances regarding the role of surgery, radiotherapy (RT) and chemotherapy in the management of recurrent LGG. There is increasing evidence to support maximal EOR for treating recurrent LGG, as it may improve progression free survival (PFS) after recurrence and overall survival (OS)...
September 30, 2016: Clinical Neurology and Neurosurgery
Nidan Qiao, Zhao Ye, Xuefei Shou, Yongfei Wang, Shiqi Li, Min Wang, Yao Zhao
OBJECTIVE: The relationship between functional and structural measurements is of fundamental importance in monitoring treatment and progression in patients with pituitary adenoma. In the present study, we examined the association between longitudinal changes in standard automated perimetry (SAP), retinal nerve fiber layer (RNFL) thickness and multifocal visual evoked potential (mfVEP) amplitude after transsphenoidal surgery. METHODS: Thirty patients with pituitary adenoma were recruited from Huashan Hospital between September 2010 and January 2014...
September 6, 2016: Clinical Neurology and Neurosurgery
Tatsuya Ueno, Haruo Nishijima, Rie Haga, Masahiko Tomiyama
No abstract text is available yet for this article.
November 2016: Clinical Neurology and Neurosurgery
So Hee Park, Ikchan Jeon, Sang Woo Kim
OBJECTIVE: The aim of this study is to evaluate the values of ProSet magnetic resonance coronal source imaging (ProSet MR imaging) as a diagnostic tool for detecting symptomatic lesion in patients with multiple lumbar foraminal stenosis. PATIENTS AND METHODS: From January 2011 to June 2015, 46 patients with unilateral and single-level radiculopathy developed from foraminal stenosis were enrolled in the study. These diagnoses were confirmed with transforaminal selective nerve root block (SNRB) and electrophysiological testing, including electromyography and nerve conduction velocity (EMG/NCV) tests...
November 2016: Clinical Neurology and Neurosurgery
Patrick M House, Stefan R G Stodieck
OBJECTIVE: Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure without a space-occupying cerebral lesion, venous sinus thrombosis or hydrocephalus and with normally composited cerebrospinal fluid (CSF). Main symptoms are headache, sight disturbances and potential visual impairment. Weight loss, carbonic anhydrase inhibitors, lumbar punctures with CSF drain, CSF shunting, optic nerve sheath fenestration, and venous sinus stenting are common IIH therapies...
November 2016: Clinical Neurology and Neurosurgery
Sanjay Konakondla, Mayur Jayarao, Jami Skrade, Caterina Giannini, Michael J Workman, Chad J Morgan
INTRODUCTION: The well-described entity of Subependymal Giant Cell Astrocytoma (SEGA) in the setting of Tuberous Sclerosis Complex (TSC) is profound in current literature. It has been described in children as well as adults with or without identifiable clinical presentations of tuberous sclerosis. To our knowledge there has not been any report of a negative genetic workup of Tuberous Sclerosis Complex in an adult patient presenting with an isolated SEGA. CASE REPORT: We present a case of a 25-year-old female with no medical history who presented to the emergency room for headaches...
November 2016: Clinical Neurology and Neurosurgery
Adolfo Ramirez-Zamora, Brian Kaszuba, Lucy Gee, Julia Prusik, Eric Molho, Meghan Wilock, Damian Shin, Julie G Pilitsis
OBJECTIVES: Dystonic tremor (DT) is defined as a postural/kinetic tremor occurring in the body region affected by dystonia. DT is typically characterized by focal tremors with irregular amplitudes and variable frequencies typically below 7Hz. Pharmacological treatment is generally unsuccessful and guidelines for deep brain stimulation (DBS) targeting and indications are scarce. In this article, we present the outcome and neurophysiologic data of two patients with refractory, focal limb DT treated with Globus Pallidus interna (Gpi) DBS and critically review the current literature regarding surgical treatment of DT discussing stereotactic targets and treatment considerations...
November 2016: Clinical Neurology and Neurosurgery
Ryan B Kochanski, Mena G Kerolus, Gian Pal, Leo Verhagen Metman, Sepehr Sani
OBJECTIVES: Intraoperative computed tomography (iCT) is currently used to confirm the target location of the microelectrode (ME) during microelectrode recording (MER) and ultimate location of deep brain stimulation (DBS) leads at our institution. We evaluated whether iCT can be used to predict the trajectory and accuracy of the ME track. PATIENTS AND METHODS: Intraoperative imaging profiles of ten consecutive patients who had undergone DBS surgery were retrospectively reviewed...
November 2016: Clinical Neurology and Neurosurgery
Yang Yuan, Mao Yunhe, Wang Xiang, Liu Yanhui, Liang Ruofei, Luo Jiewen, Mao Qing
BACKGROUND: Tumor location, which serves as a prognostic factor for high-grade gliomas, may reflect the molecular and genetic phenotype of tumor initiate cells and thus predict tumor origin. Therefore, the purpose of this study was to combine radiographic atlases and tumor biomarkers through a voxel-based neuroimaging approach. METHODS: Preoperative MRIs were collected from 65 newly diagnosed patients with histologically confirmed high-grades gliomas. These samples were analyzed for TP53 mutations and MMP-9...
November 2016: Clinical Neurology and Neurosurgery
Yavuz Samanci, Yeşim Karagöz, Mehmet Yaman, İbrahim Burak Atçı, Ufuk Emre, Nuri Özgür Kılıçkesmez, Suat Erol Çelik
OBJECTIVE: To determine the accuracy of median nerve T2 evaluation and its relation with Boston Questionnaire (BQ) and nerve conduction studies (NCSs) in pre-operative and post-operative carpal tunnel syndrome (CTS) patients in comparison with healthy volunteers. METHODS: Twenty-three CTS patients and 24 healthy volunteers underwent NCSs, median nerve T2 evaluation and self-administered BQ. Pre-operative and 1st year post-operative median nerve T2 values and cross-sectional areas (CSAs) were compared both within pre-operative and post-operative CTS groups, and with healthy volunteers...
November 2016: Clinical Neurology and Neurosurgery
Leonel Ampie, Winward Choy, Jonathan B Lamano, Kartik Kesavabhotla, Rajwant Kaur, Andrew T Parsa, Orin Bloch
INTRODUCTION: While preoperative embolization is often reserved for large and highly vascular tumors in order to minimize blood loss, its safety and efficacy in the treatment of hemangioblastomas (HB) is unclear. We present the largest systematic review focusing on the safety and outcome of preoperative embolization of intracranial HB. MATERIALS AND METHODS: To identify all cases of preoperative embolization for HB, a literature search was conducted via Medline (OVID and PubMed), Scopus, Embase, and Web of Science...
November 2016: Clinical Neurology and Neurosurgery
Kai Zhao, Xiaomin Liu, Dong Liu, Yanhe Li, Zhiyuan Zhang, Yiguang Lin, Yipei Zhang, Desheng Xu
OBJECTIVE: To analyze the feasibility and effectiveness of fractionated Gamma Knife surgery (FGKS) for giant pituitary adenomas. METHODS: From June 2005 to May 2016, 14 patients with giant pituitary adenomas were treated with FGKS, and 10 patients (71%) completed follow-up evaluation. All patients had undergone surgical resection at least once prior to FGKS. The median-volume of the adenomas was 17.6cm(3)(range 4.9-61cm(3)). RESULTS: The median follow-up period was 31...
November 2016: Clinical Neurology and Neurosurgery
Christopher S Hong, Eric C Peterson, Dale Ding, Samir Sur, David Hasan, Aaron S Dumont, Nohra Chalouhi, Pascal Jabbour, Robert M Starke
While intervention for ruptured arteriovenous malformations (AVMs) of the brain is typically warranted, the management of unruptured AVMs remains controversial. Despite numerous retrospective studies, only one randomized controlled trial has been conducted, comparing the role of medical management alone to medical management plus surgical and/or radiosurgical intervention in patients with unruptured AVMs: A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA). To great controversy, ARUBA concluded that medical management alone was superior to intervention for unruptured AVMs, which was subsequently challenged by various single-institution and multi-center studies analyzing outcomes of ARUBA-eligible patients...
November 2016: Clinical Neurology and Neurosurgery
Ádám Annus, Anett Csáti, László Vécsei
The transmissible spongiform encephalopathies, which include Creutzfeldt-Jakob disease, are fatal neurodegenerative disorders caused by the pathological accumulation of abnormal prion protein. The diagnosis of Creutzfeldt-Jakob disease is complex. The electroencephalogram, magnetic resonance imaging, lumbar puncture and genetic testing findings can help in the differential diagnosis of rapidly progressive dementia. There has recently been considerable debate as to whether proteins involved in the development of neurodegenerative diseases should be regarded as prions or only share prion-like mechanisms...
November 2016: Clinical Neurology and Neurosurgery
Fariborz Rahimi, Angela C Roberts, Mandar Jog
OBJECTIVES: Freezing of gait (FoG) is a challenging clinical symptom in Parkinson's disease with variable improvements in FoG with rasagiline. In this prospective, uncontrolled, pre-/post- treatment pilot study, we explore the clinical variables that contribute to this variability and those that predict improvement. PATIENTS AND METHODS: Frequency and duration of FoG, along with other standardized scales, were evaluated in 18 optimally medicated PD participants with intractable FoG, prior to and after completion of a 90-day course of 1mg daily rasagiline...
November 2016: Clinical Neurology and Neurosurgery
Oluwaseun O Akinduro, Griffin R Baum, Brian M Howard, Gustavo Pradilla, Jonathan A Grossberg, Gerald E Rodts, Faiz U Ahmad
BACKGROUND: Iatrogenic vascular injury is a feared complication of posterior atlanto-axial instrumentation. A better understanding of clinical outcome and management options following this injury will allow surgeons to better care for these patients. The object of the study was to systematically review the neurologic outcomes after iatrogenic vascular injury during atlanto-axial posterior instrumentation. METHODS: We performed a systematic review of the Medline database following PRISMA guidelines...
November 2016: Clinical Neurology and Neurosurgery
Wael Mohamed Mohamed Moussa, Wael Khedr
OBJECTIVES: Percutaneous radiofrequency denervation of the medial dorsal branch is often used in chronic low back pain of intervertebral facet etiology, which is sometimes difficult to perform and recurrence of pain often ensues. We theorized that shifting the target of RF coagulation to the facet joint capsule would provide an easier target and a longer-lived pain relieving response. PATIENTS AND METHODS: A prospective randomized controlled trial where 120 patients diagnosed with CLBP of a confirmed facet origin were randomly divided into three equal groups, the first was submitted to percutaneous radiofrequency coagulation of the facet joint capsule, the second underwent percuataneous denervation of the medial dorsal branch and the third did not receive radiofrequency lesioning...
November 2016: Clinical Neurology and Neurosurgery
Ying Wan, Yi Luo, Jing Gan, Rongguo Hu, Mingzhu Zhou, Zhenguo Liu
OBJECTIVE: It is reported that neurodegenerative markers of Parkinson's disease occur in patients with idiopathic rapid eye movement sleep behavior disorder (idiopathic RBD); however, it has been unknown in Chinese patients. This study aims to provide a detailed understanding of the clinical features of Chinese patients with idiopathic RBD. METHODS: We conducted a series of Parkinson related motor and non-motor assessments in 181 participants including 41 patients with idiopathic RBD, 35 Parkinson's patients without RBD, 42 Parkinson's patients with RBD, and 63 healthy controls...
November 2016: Clinical Neurology and Neurosurgery
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