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Durga Girish Joshi, Ganesh Balthillaya, Anupama Prabhu
BACKGROUND: The existence of continuity between fascia and muscles that may be anatomically distant from each other is emphasized in the tensegrity principle. Despite evidence from in vitro studies, there is a dearth of literature concerning the in vivo behavior of these connections. AIM: To compare the effect of Static Stretching (SS) of hamstrings with remote Myofascial Release (MFR) (bilateral plantar fascia and suboccipital region) and a combination of SS and remote MFR on hamstring flexibility...
July 2018: Journal of Bodywork and Movement Therapies
Ching-Chang Chen, Chi-Tung Cheng, Po-Chuan Hsieh, Chun-Ting Chen, Yi-Ming Wu, Chien-Hung Chang, Alvin Yi-Chou Wang
BACKGROUND: A ruptured vertebral artery dissecting aneurysm (VADA) with a high clinical grade (Hunt and Hess [H&H] grade V) has a devastating prognosis. Because of the high rebleeding nature and location, the rapid mortality can occur in patients due to brainstem compression. Adjuvant decompression of the posterior fossa (PF) after aneurysm secured might improve the outcomes of these patients. METHODS: Between January 2011 and December 2016, 22 patients who presented with H&H Gr...
August 7, 2018: World Neurosurgery
Shoko Yoshimoto, Keisuke Takai, Koichi Takahashi, Toshio Yasui, Makoto Taniguchi
Gorham-Stout disease (GSD) is an intractable disease characterized by massive osteolysis caused by abnormal lymphangiogenesis in bone. In rare cases of GSD, CSF abnormalities develop. The authors present the case of a 19-year-old woman with GSD presenting with orthostatic headache due to intracranial hypotension (5 cm H2 O). The clinical course of this case was very unusual. Orthostatic headache was associated with a CSF leak from the thigh after pathological fractures of the femur and pelvis. The chronic CSF leak led to acquired Chiari malformation (CM) with syringomyelia...
August 3, 2018: Journal of Neurosurgery. Pediatrics
Juliette Hordeaux, Christian Hinderer, Tamara Goode, Nathan Katz, Elizabeth L Buza, Peter Bell, Roberto Calcedo, Laura K Richman, James M Wilson
Mucopolysaccharidosis type I is a recessive genetic disease caused by deficiency of the lysosomal enzyme α-L-iduronidase, which leads to a neurodegenerative and systemic disease called Hurler syndrome in its most severe form. Several clinical trials are evaluating adeno-associated virus serotype 9 (AAV9) for the treatment of neurodegenerative diseases. Although these trials focus on systemic or lumbar administration, intrathecal administration via suboccipital puncture into the cisterna magna has demonstrated remarkable efficacy in large animals...
September 21, 2018: Molecular Therapy. Methods & Clinical Development
Juliette Hordeaux, Christian Hinderer, Tamara Goode, Elizabeth L Buza, Peter Bell, Roberto Calcedo, Laura K Richman, James M Wilson
Hunter syndrome is an X-linked recessive disease caused by deficiency of the lysosomal enzyme iduronate-2-sulfatase. The severe form of this progressive, systemic, and neurodegenerative disease results in loss of cognitive skills and early death. Several clinical trials are evaluating adeno-associated virus 9 for the treatment of neurodegenerative diseases using systemic or intrathecal lumbar administration. In large animals, administration via suboccipital puncture gives better brain transduction than lumbar administration...
September 21, 2018: Molecular Therapy. Methods & Clinical Development
Vanessa González-Rueda, Carlos López-de-Celis, Ana García-Barrull, Miriam Cid-Quintas, Aurore Bonnet, Andoni Carrasco-Uribarren, Martín Eusebio Barra-López
BACKGROUND: Hypomobility on a cervical segment is a frequent finding which is sometimes asymptomatic. The effects of inhibitory suboccipital techniques on cervical mobility have not been evaluated. OBJECTIVE: To compare the effect on cervical mobility, of pressure maintained suboccipital inhibition manual technique versus a self-treatment using an Occipivot cushion, in asymptomatic subjects with limited mobility assessed by the flexion-rotation test. METHODS: Before-after randomized uncontrolled trial...
July 20, 2018: Journal of Back and Musculoskeletal Rehabilitation
Jay Ahn, Melissa Duran, Samantha Syldort, Asad Rizvi, Anthony V D'Antoni, Jaspreet Johal, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs
INTRODUCTION: The arcuate foramen is an anatomic variant that is thought to arise from the ossification of the posterior atlanto-occipital membrane. Due to potential entrapment of the vertebral artery segment that traverses the foramen, vertebrobasilar ischemia might occur and the person may experience vertigo, headache, and/or neck pain. METHODS: Herein, we review the literature regarding the anatomy, both human and comparative, embryology, nomenclature, pathology, and surgery of the arcuate foramen...
July 16, 2018: World Neurosurgery
Jianping Song, Wei Hua, Zhiguang Pan, Wei Zhu
Pineal tumor that extends into the posterior portion of the third ventricle is extremely deep-seated and surgically challenging. Various microscopic approaches have been introduced to acquire access to the posterior third ventricle, but still the exposure and visualization are relatively unfavorable. However, recently the application of high-definition endoscope gave neurosurgeons a much more magnified and clearer view of anatomy around the pineal region and third ventricle. The widely used supracerebellar infratentorial approach has been proven to offer a sufficient surgical corridor for fully endoscopic surgery for pineal tumor...
July 13, 2018: Operative Neurosurgery (Hagerstown, Md.)
Xiao-Chun Wang, Yan-Yao Du, Yan Tan, Jiang-Bo Qin, Le Wang, Xiao-Feng Wu, Liang Xin, Lei Zhang, Li-Na Li, Xin Zhou, Dui-Ping Feng, Guo-Lin Ma, Hui Zhang
BACKGROUND: Dural arteriovenous fistulas (DAVF) at the craniocervical junction are quite uncommon, and clinical manifestations range from acute/chronic myelopathy to subarachnoid hemorrhage (SAH) to brainstem dysfunction. In this report, we presented four cases of DAVFs at the craniocervical junction with progressive brainstem dysfunction, and investigated the typical imaging features using T2 WI, SWI, DWI and contrast enhanced images. Literature was reviewed and revealed 10 case reports of DAVFs at the craniocervical junction presenting with brainstem dysfunction...
July 13, 2018: World Neurosurgery
Alireza Hedjrat, Konrad Schwager, Erich Hofmann, Robert Behr
Objective  Vestibular schwannomas (VSNs) account for the vast majority of lesions located in the cerebellopontine angle (CPA). The goals of VSN surgery are possible total tumor removal, intact facial nerve function, and preservation of cochlear nerve function. In cases of pre- or postoperative deafness, restoration of hearing with auditory brainstem implant (ABI) or cochlear implant (CI) is a promising treatment option with normally better results in CI than in ABI. The aim of this retrospective study is to evaluate cochlear ossification or obliteration secondary to a retrosigmoid approach, which is important for later CI, especially in single-sided deafness...
August 2018: Journal of Neurological Surgery. Part B, Skull Base
Pei Liu, Chan Li, Nan Zheng, Xiaoying Yuan, Yutong Zhou, Pu Chun, Yanyan Chi, Campbell Gilmore, Shengbo Yu, Hongjin Sui
Recent studies have identified that the myodural bridge (MDB) is located between the suboccipital muscles and cervical dura mater in the posterior atlanto-occipital interspace within humans. The myodural bridge has been considered to have a significant role in physiological functions. However, there is little information about the myodural bridge in marine mammals; we conducted this study to investigate and examine the morphology of the myodural bridge in a sperm whale. We also aim to discuss the physiological functions of the myodural bridge...
2018: PloS One
Shyam Sundar Krishnan, Pulak Nigam, Poonam Mohanty, Madabhushi Chakravarthy Vasudevan, Mohan Kameswaran
INTRODUCTION: Auditory brainstem implant (ABI), a standard technique in treatment of profound sensorineural hearing loss in patients with neurofibromatosis 2, is now being increasingly employed in children with congenital bilateral sensorineural hearing loss, as in Michele's deformity. A detailed knowledge of the relevant surgical anatomy of the lateral recess and its anatomical landmarks including the flocculus, the choroid plexus and the root entry zones of facial-vestibulocochlear and glossopharyngeal-vagus nerve complexes and their anatomical variants is mandatory, as it is the conduit for electrode array placement...
June 8, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Joham Choque-Velasquez, Franklin Miranda-Solis, Roberto Colasanti, Luis Angel Ccahuantico-Choquevilca, Juha Hernesniemi
OBJECTIVE: In the last decades endoscopic techniques have been increasingly used in neurosurgery as they may offer a valuable close-up view of the working area through a minimally invasive surgical corridor. Herein, we present an inexpensive and efficient endoscopic surgical model using a borescope, which was used for a "modified pure endoscopic approach" to the pineal region. METHODS: A borescope video camera was connected to a 16 inches personal computer monitor...
June 20, 2018: World Neurosurgery
Eveline Teresa Hidalgo, Yosef Dastagirzada, Cordelia Orillac, Svetlana Kvint, Emily North, Ramona Bledea, Michelle W McQuinn, Gabriel Redel-Traub, Crystalann Rodriguez, Jeffrey H Wisoff
BACKGROUND: Duraplasty is a technique successfully used to treat Chiari malformation type I (CM-I). This study describes the timely manner of clinical outcomes and the postoperative course after craniectomy and duraplasty for the treatment of symptomatic CM-I in children. METHODS: A retrospective chart review was performed in 105 consecutive children who underwent surgical decompression of symptomatic CM-I with dural opening by a single surgeon between 1999 and 2015...
June 20, 2018: World Neurosurgery
Yuuki Suematsu, Go Takeishi, Kiyotaka Yokogami, Hisao Uehara, Toshihiro Gi, Atsushi Yamashita, Yuichiro Sato, Hideo Takeshima
An epidermoid cyst is a benign tumor, accounting for 0.2-1.8% of all brain tumors. Histologically, an epidermoid cyst has a wall consisting of squamous epithelium with keratinization and without skin components. An epidermoid cyst tends to develop in the cerebellopontine angle(CPA), middle cranial fossa, pituitary fossa, spinal cord, and other locations. We describe a rare case of malignant transformation of an epidermoid cyst with cerebrospinal fluid(CSF)dissemination. A 54-year-old man was referred to our hospital with chief complaints of dysesthesia of the right leg, persisting for 6 months, and dizziness and dysarthria for 2 months...
June 2018: No Shinkei Geka. Neurological Surgery
Monique M Montenegro, Jeremy K Cutsforth-Gregory
OBJECTIVE: To review the clinical and radiographic characteristics of orthostatic headache following suboccipital craniectomy without CSF leak after encountering 2 such patients. BACKGROUND: Orthostatic headache may occur without CSF leak, suggesting alternative mechanisms for postural head pain in some patients. METHODS: Patients who were referred for orthostatic headache and suspected CSF leak within 1 year after suboccipital craniectomy but who had negative post-operative head and spine MRI, normal radioisotope cisternography, and normal or elevated CSF opening pressure were identified and their medical records reviewed...
June 19, 2018: Headache
Ricardo Chmelnitsky Wainberg, Marcos Devanir Silva da Costa, Yair A Ugalde Hernández, Ricardo Lourenço Caramanti, César Augusto Ferreira Alves Filho, Helbert Palmiero, Ricardo Pagung Saick, Feres Chaddad-Neto
The distal posterior inferior cerebellar artery (PICA) is a rare site of aneurysm formation. Only small case series and case reports regarding surgical treatment are found in the literature.The PICA is divided into 5 segments (anterior medullary, lateral medullary, tonsilomedullary, telovelotonsillary, and cortical), and the distal ones represent the most complex, due to anatomic variations. We present a case of a 69-yr-old female patient who has suffered from a sudden and intense occipital headache, associated with nausea and vomiting...
June 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
Alberto Di Somma, Paloma Cancela, Magdalena Olivares, Teresa Somma, Antonio López-González, Alvaro Campero, Juan Emmerich, Javier Márquez-Rivas
BACKGROUND: and importance: Lesions located lateral to the lower brainstem, such as proximal posterior inferior cerebellar artery (PICA) aneurysms, are surgically challenging. In this study we report a case of a patient with a left proximal PICA aneurysm that was successfully clipped via a so-called "extended" suboccipital subtonsillar approach, which allowed to obtain proper vascular control without removal of the atlas. The anatomy relevant for this approach has been studied...
June 11, 2018: World Neurosurgery
Ahmed Farhoud, Wael Khedr, Hisham Aboul-Enein
Objective  Epidermoid cysts are benign slowly growing tumors commonly involving the cerebellopontine angle (CPA). The aim of this study was to analyze the surgical limitations, surgical strategies, complications, and outcome of resection of these lesions. Material and Methods  The clinical data and outcome of 32 cases operated for CPA epidermoid between 2007 and 2015 were retrospectively analyzed. The mean follow-up period was 42.6 months, and all patients were followed up at least for a whole year. Results  There were 15 males and 17 females...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
M Palacios-Ceña, K Wang, M Castaldo, S Fuensalida-Novo, C Ordás-Bandera, A Guillem-Mesado, L Arendt-Nielsen, C Fernández-de-Las-Peñas
Aims Some evidence supports that referred pain elicited by active trigger points (TrPs) reproduces some features of tension type headache (TTH). Our aim was to investigate the association between the number of active TrPs and health-related quality of life TTH. Methods Patients with TTH diagnosed by experienced neurologists according to the last International Headache Classification (ICHD-III) were included. Exclusion criteria included other primary headaches, medication overuse headache, whiplash injury or fibromyalgia...
December 29, 2017: Scandinavian Journal of Pain
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