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Neurosurgery Open
Number of Followers: 7  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 2633-0873 - ISSN (Online) 2633-0873
Published by LWW Wolters Kluwer Homepage  [297 journals]
  • A Long Farewell

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      Authors: Oyesiku; Nelson M.
      Abstract: imageNo abstract available
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Multiple Cervical Cutdowns of Scar Tissue to Treat Bowstringing After Deep
           Brain Stimulation: Description of Technique and Case Series

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      Authors: Graham; Dakota T.; Zhou, James J.; Lambert, Margaret; Ponce, Francisco A.
      Abstract: imageBACKGROUND: Deep brain stimulation (DBS) is widely used to treat movement disorders. One rare complication is bowstringing, the formation of scar tissue around the extension wires. This adverse effect can cause considerable pain or discomfort in the cervical region. Limited information is available about the best surgical technique to address this complication.OBJECTIVE: To present and describe a surgical technique (cervical cutdown [CCD]) to treat bowstringing.METHODS: We retrospectively reviewed records of DBS patients treated with CCD for bowstringing (August 1, 2011-February 28, 2020) to identify parameters that preceded the condition, evolution of the treatment technique, and patient outcomes.RESULTS: Nine patients (mean age, 61 years) underwent 10 CCD procedures for bowstringing. One patient required repeat CCD for retethering 10 months after the initial CCD. The mean time from DBS to presentation for initial bowstringing was 25 months. Six patients had undergone DBS surgery at our institution (0.6% incidence in 1068 cases). All 9 patients had 2 extension wires tunneled unilaterally. During each CCD, 2 to 4 cervical incisions were made. In 7 of the 10 cases, the internal pulse generator pocket was reopened; the extension wires were detethered in 4, and the internal pulse generator was replaced in 3. Six patients with follow-up (mean, 15 months) reported that their symptoms had improved ≥50%; 3 patients were lost to follow-up.CONCLUSION: A primary risk factor of bowstringing after DBS is likely the unilateral routing of 2 extension wires. CCD surgery is effective for symptomatic patients nonresponsive to conservative management.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • The History of Stereotactic and Functional Neurosurgery in Zurich

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      Authors: Oertel; Markus Florian; Krayenbühl, Niklaus; Baumann, Christian Rainer; Regli, Luca; Stieglitz, Lennart Henning
      Abstract: imageZurich's stereotactic and functional neurosurgery (SFN) has a rich legacy beginning with the studies of the physiologist and Nobel prize winner Walter Rudolf Hess over the efforts of the neurosurgeons Hugo Krayenbühl and Mahmut Gazi Yaşargil up to the work of the functional surgeon Jean Siegfried and the modern era of SFN and neuromodulation. A comprehensive review and synthesis of data acquired from institutional archives and personal interviews as well as from journal articles, included references, proceedings of scientific meetings, staff biographies, and book publications were performed to gain insight into Zurich's long journey toward contemporary SFN and to highlight its stereotactic and functional history with special reference to the development of deep brain stimulation. Zurich's history of medicine includes decisive moments for the fundamentals and development of SFN. After an early period of innovation and research later followed by a long time of clinical application during the 20th century, it became quieter at the turn of the century. Since the end of the 2000s, an impressive renaissance occurred in Zurich that revived its rich SFN tradition.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Delayed HSV-1 Encephalitis Relapse After Epilepsy Surgery: A Case Report

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      Authors: Johnson; Gabrielle W.; Han, Rowland H.; Gupta, Vivek P.; Leuthardt, Eric C.
      Abstract: imageBACKGROUND AND IMPORTANCE: Herpes simplex virus 1 encephalitis (HSVE) can be a rare postoperative complication after neurosurgery. We present the case of a patient with postoperative, twice recurrent HSVE after 20 years, the longest latency period reported after neurosurgery.CLINICAL PRESENTATION: A 21-year-old man with a history of HSVE at 13 months and intractable epilepsy presented for surgical resection of seizure focus. The patient underwent left temporal craniotomy and resection of left temporal encephalomalacia. Five days after discharge, the patient presented with fever and headache and was found to have herpes simplex virus 1 (HSV-1)–positive cerebral spinal fluid. The infection was treated with acyclovir, with subsequent symptomatic improvement. Six weeks later the patient represented with recurrent symptoms and HSV-1–positive cerebral spinal fluid. This recurrence was treated with a prolonged course of acyclovir, followed by suppressive valacyclovir therapy, resulting in symptomatic improvement.CONCLUSION: HSV-1 encephalitis is a rare but previously reported complication after neurosurgery procedures. In patients with relapse of HSVE, the latency period can range from weeks to years after primary infection, and multiple relapses are rare. We present the case of a patient with twice recurrent, postoperative HSV-1 encephalitis 20 years after initial infection. We aim to emphasize that HSV status should be considered during treatment planning in patients with a history of HSVE being treated for HSV-related illnesses, and HSVE should remain on the differential in these patients when presenting with fever and neurological symptoms after surgery, regardless of time since initial infection.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Microvascular Decompression for Hypoglossal Nerve Palsy Associated With
           Vertebral Artery: Case Report and Review of Literature

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      Authors: Shafizadeh; Milad; Maroufi, Seyed Farzad; Ahmadi, Maryam; Khoshnevisan, Alireza
      Abstract: imageBACKGROUND AND IMPORTANCE: Hypoglossal nerve palsy is an infrequent condition that could be rarely caused by compression from nearing vasculature. Hypoglossal nerve palsy associated with vertebral artery (VA) is rarely reported. There are less than 15 cases of such conditions in the literature.CLINICAL PRESENTATION: We present a 17-year-old boy suffering from dysarthria, chewing disability, a tingling sensation, and deviation of the tongue to the right from 6 months ago. After a thorough examination, MRI was performed with clinical suspicion of hypoglossal nerve palsy, and the result showed an ectatic VA pressing against the right hypoglossal nerve. He underwent microvascular decompression surgery. On follow-up visits, he showed gradual improvement of symptoms.CONCLUSION: In cases of cranial nerve palsies, compression by adjacent vasculature should be considered as a differential diagnosis and microvascular compression should be considered as a safe definitive treatment.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Representation of Women as Neurological Surgery Society Award Recipients

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      Authors: Johnson; Gabrielle W.; Almgren-Bell, Alison; Skidmore, Alexander; Raval, Dhvanii; Blow, Gretchen; Mackey, Kimberly A.; Groves, Mari L.; Lee, Hedwig; Strahle, Jennifer M.
      Abstract: imageBACKGROUND: Women comprise more than half of medical school matriculants, but only 8.4% of US neurosurgeons. Awards given by neurosurgical societies are instrumental in shaping and advancing careers of women within academic neurosurgery, which can serve to increase the pipeline of women in the field.OBJECTIVE: To quantify the gender diversity of awards given by neurosurgical societies over 54 years.METHODS: Awards given by the American Association of Neurological Surgeons, Congress of Neurological Surgeons, and American Association of Neurological Surgeons/Congress of Neurological Surgeons joint sections were classified as research, humanitarian/achievement, or lectureships and analyzed for gender. Composite gender data were obtained from the societies. Percentage differences were calculated using comparison of proportions testing.RESULTS: Ninety six distinct awards granted to 1281 individuals from 1965 to 2019 were analyzed, and 9.4% were awarded to women. Seven percent of neurosurgeon awardees were women (excluding Women in Neurosurgery Section [WINS] awards). 36.1% of awards given at least 5 times were never awarded to women. Female awardees increased from 2000-2009 to 2010-2019 (5.2% difference, P = .018). The Cerebrovascular (2.0%) and Spine (2.3%) sections awarded the fewest awards to women, whereas the WINS (73.3%) and Pediatric section (20.6%) awarded the most. Spine, WINS, Pain, Cerebrovascular, and Tumor sections awarded significantly fewer awards to women than respective society demographic proportions. One-hundred percent (39 of 39) of named awards (excluding 2 from WINS) were named after men.CONCLUSION: Women remain underrepresented in the field of neurosurgery and as award winners. Many subspecialty sections continue to give significantly fewer awards to women than their society demographic proportions.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
 
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