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Mathias Kunz, Philipp Karschnia, Ingo Borggraefe, Soheyl Noachtar, Joerg-Christian Tonn, and Christian Vollmar

. Indeed, some studies reported limited success of reoperations. 12 , 13 However, the recent methodological progress in presurgical reevaluation, refined neuroimaging, and 3D localization of the EZ with stereo-EEG (sEEG) might pave the avenue for better outcome after reoperations. 10 We herein describe our protocol for the reevaluation of recurrent or persistent seizures after initial epilepsy surgery and the respective clinical outcome on a cohort of 38 consecutive patients who underwent repeat epilepsy surgery. Methods Study Population We searched our

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Lara E. Jehi, Diosely C. Silveira, William Bingaman, and Imad Najm

frequency and timing of first seizure recurrence are very useful indicators in this regard ( Table 1 ): an almost 100% yield of a repeat evaluation was seen in patients who had at least 4 seizures per month with recurrences starting within a year of surgery, suggesting that this might be the ideal population for reevaluation. This yield dropped to less than 1 in 5 if neither criterion was fulfilled and to about 60% if only 1 was ( Table 7 ), suggesting that it might be advisable to wait and exhaust medical therapy before initiating a second surgical evaluation in this

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Henry Kurzydlowski, Cynthia Wollenschlager, Frank R. Venezio, Mona Ghobrial, Morris Marc Soriano, and O. Howard Reichman

T o study the efficacy of newer antimicrobial agents in the treatment of brain abscess, we employed a canine model in which alpha-hemolytic Streptococci were inoculated into the brain parenchyma. Although well-circumscribed ring-like lesions were visualized by computerized tomography (CT), they resolved without therapeutic intervention. This unexpected finding prompted the present Reevaluation of that experimental design. Results of timed sequential CT scans and histopathological findings similar to those of previous studies 5, 6, 9 are presented

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Chisato Araki and Satoshi Matsumoto

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Gaylan L. Rockswold, Shelley N. Chou, and William E. Bradley

✓ The authors describe long-term follow-up results (4 to 6 years) in 13 patients who underwent differential sacral rhizotomy for urgency incontinence. Six patients were originally presented in a preliminary report in 1973. In the last seven patients, a highly selective rhizotomy of sacral fascicles innervating only the urinary bladder was performed. Results in the original six patients appear to be superior to those in patients who underwent a more refined rhizotomy. Possible explanations for this as well as alternative approaches to the treatment of urgency incontinence are briefly discussed.

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Liang Xu, Yong Qiu, Zhonghui Chen, Benlong Shi, Xi Chen, Song Li, Changzhi Du, Zezhang Zhu, and Xu Sun

OBJECTIVE

This study aimed to evaluate the correction results of traditional dual growing rods (DGRs) on axial rotation using CT scans and to further explore the relationships between axial and torso deformities in patients with early-onset scoliosis (EOS).

METHODS

Patients with EOS who were treated with traditional DGRs between January 2006 and December 2014 were retrospectively reviewed. Plain radiographs were used to assess the degree of coronal and sagittal deformity. The apical vertebral rotation (AVR) and rib hump (RH) were measured on CT scans at the apical vertebra. Pearson or Spearman rank correlation analyses were used to analyze the associations between spinal and torso deformities.

RESULTS

A total of 27 patients (10 boys and 17 girls, average age 6.5 ± 1.7 years) were enrolled in this study. The average number of lengthenings per patient was 5.0 ± 1.9, with a mean follow-up duration of 52.9 ± 18.2 months. The apical vertebral translation, apical vertebral body–rib ratio (AVB-R), AVR, and RH parameters were significantly decreased after the initial surgery (p < 0.05) but showed notable progression at the latest follow-up evaluation (p < 0.05). The preoperative AVR and its correction after index surgery were significantly correlated with the preoperative values as well as with the corrections of the major Cobb angle, AVB-R, and RH. During the follow-up period, significant correlations were found between the deterioration of AVR and the AVB-R and also between the deterioration of AVR and the RH from the initial surgery to the latest follow-up.

CONCLUSIONS

Significant AVR correction can be achieved by DGR techniques after the initial surgery. However, this technique weakly prevents the deterioration of AVR during the follow-up period.

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Mauricio Collada Jr., Joseph Kott, and David G. Kline

the history of truncal ataxia raised the question of entrapment of the fourth ventricle superimposed on a malfunctioning supratentorial shunt. Fig. 1. Case 1. Left: Plain CT scan obtained on admission shows the ventricular system is enlarged. The fourth ventricle is disproportionately enlarged, suggesting fourth ventricle entrapment. Right: After the administration of metrizamide, the contrast medium flows easily through the supratentorial portion of the ventricular system but never fills the fourth ventricle. Reevaluation of the CSF pathways was

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Roland N. Auer, James Budny, Charles G. Drake, and Melvyn J. Ball

abnormality. After his symptoms cleared, he was discharged. Angiography was repeated in October, 1978. There was only slight shift of the anterior cerebral artery from right to left. He remained asymptomatic until his last admission for reevaluation. Examination . There was flattening of the right nasolabial fold, but his sense of smell was notably intact. A CT scan revealed a calcium-containing right frontal and subfrontal mass, with surrounding hypodensity ( Fig. 1 ). There was some contrast enhancement of the inferior portion of the lesion. Cerebral angiography

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Zacharias Kapsalakis, Helen C. Askitopoulou, and Athanasios Gregoriades

treatment of the primary source of infection, systemic use of steroids, and reevaluation of the patient before discharge. Although the number of our cases is too small to be of statistical significance, it is our feeling that this policy has contributed to our low mortality rate of one death in 12 treated cases. Antibiotics Chloramphenicol penetrates many tissues including brain and the meninges with ease, 3, 4 and is effective in inhibiting most of the organisms responsible for brain abscesses. For this reason chloramphenicol was given in all but one of our cases

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Edwin Ramos, Selim Benbadis, and Fernando L. Vale

analysis is low. Patients in whom initial surgical intervention failed (Group B, 8 patients) were studied again by the epilepsy team according to a specified protocol ( Fig. 1 ). In Group B, seizures recurred within 1 year, concordant with previous reports of failed surgical therapy. 5 , 13 , 38 , 55 No early recurrence (< 30 days) was seen in this group. Electrophysiological reevaluation with surface electrodes in these patients ranged from ipsilateral temporal spikes to contralateral temporal findings ( Table 1 ). No cases of extratemporal ictal onset were