Authors:Toru Satoh, Takanobu Yagi, Keisuke Onoda, Masahiro Kameda, Tatsuya Sasaki, Tomotsugu Ichikawa and Isao Date
The wall shear stress of the offending vessels at the site of neurovascular contact in patients with trigeminal neuralgia and hemifacial spasm was investigated via computational fluid dynamics analysis. Findings of a relatively high magnitude and less mobility of the wall shear stress along the areas in contact with the affected nerve may be useful for diagnosis and for planning for microvascular decompression.
Authors:Mark G. Bigder, Sandeep Krishnan, E. Francis Cook and Anthony M. Kaufmann
The authors report their experience with microsurgical partial sensory rhizotomy (MSR) in treating multiple sclerosis (MS) patients suffering with MS-related trigeminal neuralgia (MS-TN). Time to treatment failure was significantly longer after MSR compared to prior percutaneous and radiosurgical procedures. All patients experienced postoperative pain relief with reductions or cessation of medications and minimal morbidity. The results support the use of MSR as a treatment option for MS-TN and its consideration at an earlier stage in the disease course.
Authors:Spencer Twitchell, Michael Karsy, Jian Guan, William T. Couldwell and Philipp Taussky
With more aggressive cancer treatment, more patients experience long-term survival after diagnosis, but decades later these patients may face after-effects of their initial radiation treatment. Radiation vasculopathy is a heterogeneous and poorly defined entity, and neurosurgeons often face unique clinical challenges when dealing with radiation vasculopathy of the head and neck. In this review, the authors discuss the often-delayed complex pathophysiology of radiation vasculopathy, diagnostic challenges, and individualized treatment modalities.
Although the benefit of extracranial-intracranial bypass surgery has not been identified previously, the outcomes of initial symptomatic ischemic stroke and stenosis and/or occlusion among the Asian population in patients with or without bypass intervention have yet to be discussed. The authors thus evaluated the vascular outcomes in patients with and without a history of this intervention. Bypass surgery reduces the risk of ischemia; however, hemorrhage risk and mortality were still high after intervention. This study highlights the fact that the high risk of the surgery itself obscures the true benefit of rescuing the brain from ischemia, and also demonstrates the importance of improved surgical techniques in treating these high-risk patients.
Authors:Hubert Lee, Jeffrey J. Perry, Shane W. English, Fahad Alkherayf, Joanne Joseph, Steven Nobile, Linghong Linda Zhou, Howard Lesiuk, Richard Moulton, Charles Agbi, John Sinclair and Dar Dowlatshahi
Pericytes encircle endothelial cells in capillary vessels in almost all tissues and are important for the maturation and stabilization of the capillary during angiogenesis. The role of pericytes in intraplaque hemorrhage (IPH) of carotid artery stenosis is unclear. Therefore, the authors focused on pericytes and investigated the association between pericytes and IPH. They found possible involvement of pericytes in IPH of carotid artery stenosis. Their findings may help in the development of novel therapeutic agents targeting pericytes.
Authors:Stéphanie Lenck, Fabrice Vallée, Vittorio Civelli, Jean-Pierre Saint-Maurice, Patrick Nicholson, Alex Hong and Emmanuel Houdart
The authors evaluate a dual-sensor guidewire to measure both pressures and velocities across a stenotic lesion of the venous sinus in patients with pulsatile tinnitus and idiopathic intracranial hypertension. They conclude that this seems to be an effective diagnostic strategy that can help assess the indications for stenting. This combined approach for hemodynamic assessment of venous dural sinus stenoses, using both venous pressures and blood flow velocities, appears to be promising, especially in patients with a low trans-stenotic gradient (< 10 mm Hg), for which technical biases cannot be avoided.
Authors:Martin Jakobs, Sabrina Klein, Tatjana Eigenbrod, Andreas W. Unterberg and Oliver W. Sakowitz
The authors compared ease of use and infection rates for standard and silver-impregnated lumbar drains in 48 patients as well as testing for silver susceptibility of all isolated microorganisms. Drain-related CSF infections are common and severe complications, especially in critically ill patients in need of temporary CSF drainage, and reducing the number of CSF-related infections could lead to better outcomes and shorter hospital stays.
Authors:Sanjeet S. Grewal, Richard S. Zimmerman, Gregory Worrell, Benjamin H. Brinkmann, William O. Tatum, Amy Z. Crepeau, David A. Woodrum, Krzysztof R. Gorny, Joel P. Felmlee, Robert E. Watson, Joseph M. Hoxworth, Vivek Gupta, Prasanna Vibhute, Max R. Trenerry, Timothy J. Kaufmann, W. Richard Marsh, Robert E. Wharen Jr. and Jamie J. Van Gompel