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L. Dade Lunsford, Ajay Niranjan, John C. Flickinger, Ann Maitz and Douglas Kondziolka

have no data to substantiate this allegation based on our experience in more than 800 patients. In our experience tinnitus is usually unchanged after GKS. In fact, tinnitus almost certainly represents a deafferentation phenomenon similar to chronic pain. We have noted a number of patients who are deaf after microsurgery who have residual tinnitus. There are very few cases of exacerbation of tinnitus in our patients, including those who have long-term preservation of hearing. No doubt a properly case-matched study in which the outcomes of microsurgery and

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Roy A. E. Bakay

number of papers on neurotransplantation for all varieties of neurological diseases including Alzheimer disease, multiple system atrophy, spinal cord injury, brain injury, epilepsy, chronic pain, CNS malignancy, genetic defects, ischemia, and stroke. 13 If there is so much activity in the basic sciences, why invest in clinical studies? Why not just wait until the basic scientists solve all the problems? Unfortunately, basic scientists will never solve all the problems because the models they create are not the disease; in addition feedback from the clinical sphere is

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Douglas Kondziolka, Gary K. Steinberg, Lawrence Wechsler, Carolyn C. Meltzer, Elaine Elder, James Gebel, Sharon DeCesare, Tudor Jovin, Ross Zafonte, Jonathan Lebowitz, John C. Flickinger, David Tong, Michael P. Marks, Catriona Jamieson, Desiree Luu, Teresa Bell-Stephens and Jeffrey Teraoka

axis botulinum toxin injection, phenol injection, intrathecal baclofen, or any other interventional treatments for spasticity (except bracing & splinting)  w/in previous 6 mos modified Rankin Scale Score ≥4 change in total ESS Score >3 points from screening visit to preop visit residence in skilled nursing facility or other chronic care facility gastrostomy tube or other enteral or parenteral feeding device history of seizure disorder or current use of antiepileptic medication(s) substantial cognitive deficits, aphasia

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John Y. K. Lee and Douglas Kondziolka

Neurosurg 75: 723–730, 1991 6. Goldman MS , Kelly PJ : Symptomatic and functional outcome of stereotactic ventralis lateralis thalamotomy for intention tremor. J Neurosurg 77 : 223 – 229 , 1992 Goldman MS, Kelly PJ: Symptomatic and functional outcome of stereotactic ventralis lateralis thalamotomy for intention tremor. J Neurosurg 77: 223–229, 1992 7. Hariz MI , Shamsgovara P , Johansson F , Hariz GM , Fodstad H : Tolerance and tremor rebound following long-term chronic thalamic

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Douglas Kondziolka, Joseph G. Ong, John Y. K. Lee, Robert Y. Moore, John C. Flickinger and L. Dade Lunsford

. Adopting standard outcomes measures will be crucial to the effective comparison of results from different research groups. Acknowledgment We thank Dr. Susan Baser for her assistance in this study. References 1 Benabid AL , Pollak P , Gao D , Hoffmann D , Limousin P , Gay E , : Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders . J Neurosurg 84 : 203 – 214 , 1996 2 Fahn S , Tolosa E , Marin C , Clinical rating scale for tremor . Jankovic J , Tolosa E

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Douglas Kondziolka and Lawrence Wechsler

of chronic stroke. Acute stroke models exist, but the animals must typically be killed soon after the acute intervention. Issues related to the ethics of keeping a disabled primate alive for months, and to the technical creation of such a model have been problematic. Potential Mechanisms of Cell Transplantation Available evidence suggests both the value of humoral mechanisms from the graft, as well as a direct action of surviving implanted neuronal cells. The neuronal cells could improve neurological function through a number of different mechanisms. These

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Douglas Kondziolka

nihilism associated with this disease. If we can turn cancer into a more chronic disease managed with early detection, minimally invasive therapies, and serial imaging so that tumors are detected while small and asymptomatic, we will be able to prolong survival, maintain function and quality of life, and allow patients to participate in new research protocols that hopefully may improve the management of extracranial disease. Disclosure Dr. Kondziolka is a consultant for Elekta. Reference 1 Matsunaga S , Shuto T , Kawahara K , Suenaga N , Inomori

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Matthew J. Tormenti, Nestor D. Tomycz, Keith A. Coffman, Douglas Kondziolka, Donald J. Crammond and Elizabeth C. Tyler-Kabara

: Deep-brain stimulation of the subthalamic nucleus or the pars interna of the globus pallidus in Parkinson's disease . N Engl J Med 345 : 956 – 963 , 2001 5 Gubellini P , Eusebio A , Oueslati A , Melon C , Kerkerian-Le Goff L , Salin P : Chronic high-frequency stimulation of the subthalamic nucleus and L-DOPA treatment in experimental parkinsonism: effects on motor behaviour and striatal glutamate transmission . Eur J Neurosci 24 : 1802 – 1814 , 2006 6 Henderson JM , Dunnett SB : Targeting the subthalamic nucleus in the treatment of

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Hideyuki Kano, Douglas Kondziolka, David Mathieu, Scott L. Stafford, Thomas J. Flannery, Ajay Niranjan, Bruce E. Pollock, Anthony M. Kaufmann, John C. Flickinger and L. Dade Lunsford

C luster headache is a relatively rare periodic headache and facial pain syndrome that may persist for weeks or even months. Cluster headaches occur in 0.4% of the male population and < 0.08% of the female population. 20 Approximately 90% of patients with CH have an episodic disorder, while 10% have chronic CH. Chronic CH attacks vary, from closely spaced pain with remissions lasting no longer than 30 days, to continuous pain without remission lasting more than a year. 5 In contrast, episodic CHs are characterized by 1–3 attacks of periorbital pain per

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Hideyuki Kano, L. Dade Lunsford, John C. Flickinger, Huai-che Yang, Thomas J. Flannery, Nasir R. Awan, Ajay Niranjan, Josef Novotny Jr. and Douglas Kondziolka

, coexistence of an aneurysm, prior hemorrhage, Spetzler-Martin grade, and Pollock-Flickinger score. A value of p < 0.05 was used for statistical significance. Results At the time of this assessment, 197 patients were alive and 20 had died. Six of 20 patients died due to AVM hemorrhage and 14 died of other causes (systemic cancer in 2 patients, heart failure in 2, chronic obstructive pulmonary disease in 1, and undetermined causes other than AVM hemorrhage in 9). The median follow-up after SRS was 64 months (range 6–267 months). Obliteration Rates After SRS