Role of deep brain stimulation therapy in the magnetic resonance-guided high-frequency focused ultrasound era: current situation and future prospects.

Role of deep brain stimulation therapy in the magnetic resonance-guided high-frequency focused ultrasound era: current situation and future prospects. Expert Rev Neurother. 2019 Oct 18;: Authors: Fernandez-Garcia C, Alonso-Frech F, Monje M, Matias-Guiu J Abstract Introduction: Deep brain stimulation (DBS) is a well-established treatment of movement disorders; but recently there has been an increasing trend towards the ablative procedure magnetic resonance-guided focused ultrasound (MRgFU). DBS is an efficient neuromodulatory technique but associated with surgical complications. MRIgFUS is an incision-free method that allows thermal lesioning, with fewer surgical complications but irreversible effects. Areas covered: We look at current and prospective aspects of both techniques. In DBS, appropriate patient selection, improvement in surgical expertise, target accuracy (preoperative and intraoperative imaging), neurophysiological recordings, and novel segmented leads need to be considered. However, increased number of older patients with higher comorbidities and risk of DBS complications (mainly intracranial hemorrhage, but also infections, hardware complications) make them not eligible for surgery. With MRgFUS, hemorrhage risks are virtually nonexistent, infection or hardware malfunction are eliminated, while irreversible side effects can appear. Expert opinion: Comparison of the efficacy and risks associated with these techniques, in combination with a growing aged...
Source: Expert Review of Neurotherapeutics - Category: Neurology Tags: Expert Rev Neurother Source Type: research

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Conclusions: DDAVP was associated with a decreased likelihood of intracranial hemorrhage expansion during the first 24 hours. DDAVP administration did not significantly affect serum sodium and thrombotic events during the study period.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research
Conclusions: A large knowledge gap exists in our understanding and treatment of extracorporeal membrane oxygenation-related neurologic complications. A systematic and multidisciplinary approach is needed to reduce the prevalence of these complications and to better manage the neurologic sequelae of extracorporeal membrane oxygenation in a way that will improve patient outcomes.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Concise Definitive Review Source Type: research
We present a case of an otherwise healthy 58-year-old woman with multiple nasal polyps who underwent nasal polypectomy. The operation was initially considered successful. However, the patient had never recovered from general anesthesia and was declared deceased 24 hours after the surgery. The autopsy revealed a basilar subarachnoid hemorrhage. The examination of the basilar skull showed a perforation of approximately 15 by 7 mm in the right cribriform plate. Above the bone perforation, there was a disruption of the dura and a 20-mm-long penetrating wound within the right frontal lobe parenchyma of the brain, with associat...
Source: The American Journal of Forensic Medicine and Pathology - Category: Forensic Medicine Tags: Original Articles Source Type: research
ConclusionsA portable gamma-camera could be a useful and feasible tool for the diagnosis of BD.ResumenObjetivoEvaluar la factibilidad del empleo de la minigammacámara portátil Sentinella®, para el diagnóstico de muerte encefálica (ME).DiseñoEstudio observacional, prospectivo, de factibilidad.ÁmbitoUnidad de cuidados intensivos de un hospital de tercer nivel.PacientesDesde enero a diciembre de 2017 se registraron de forma consecutiva los pacientes mayores de edad que tras su ingreso en unidad de cuidados intensivos fueron diagnosticados de ME según criterios clínic...
Source: Medicina Intensiva - Category: Intensive Care Source Type: research
ConclusionBoth neurologic and medical complications were common in majority of stroke patients. But the management protocol for stroke patients was sub-optimal and lagging behind the recommended guidelines due to lack of skilled personnel, appropriate treatment and diagnostic agents. The clinical team involved in the care of stroke patients should make preparations to take preventive measures that will save a lot of lives.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
We describe the case of a patient who underwent tracheal resection for post-tracheostomy stenosis following T-tube stenting for 10  years. A 32-year-old female patient with a T-tube in the trachea was referred to us. She had brain surgery for intracranial hemorrhage 10 years ago and developed a post-tracheostomy tracheal stenosis, for which she had been treated with a T-tube. At the time of referral, she was ambulatory with a cane and otherwise independent in her daily life. We assessed her stenosis and determined that it was amenable to tracheal resection as a definitive treatment. We resected the tracheal steno...
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
ConclusionsChoriocarcinomas can rarely originate outside of the female reproductive tract (non-gestational, primary choriocarcinomas). In the infrequent cases where a gestational origin is clinically unlikely, the differential diagnosis includes a non-gestational primary choriocarcinoma and choriocarcinomatous differentiation in another primary malignancy. Careful correlation with imaging and clinico-pathologic studies is paramount to determining their origin and guiding further clinical treatment.
Source: Gynecologic Oncology Reports - Category: OBGYN Source Type: research
Journal Name: Clinical Chemistry and Laboratory Medicine (CCLM) Issue: Ahead of print
Source: Clinical Chemistry and Laboratory Medicine - Category: Laboratory Medicine Source Type: research
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Source: Neurocritical Care - Category: Neurology Source Type: research
Knowledge gaps exist in how we implement aerobic exercise programs during the early phases post-stroke. Therefore, the objective of this review was to provide evidence-based guidelines for pre-participation screening, mobilization, and aerobic exercise training in the hyper-acute and acute phases post-stroke. In reviewing the literature to determine safe timelines of when to initiate exercise and mobilization we considered the following factors: arterial blood pressure dysregulation, cardiac complications, blood-brain barrier disruption, hemorrhagic stroke transformation, and ischemic penumbra viability. These stroke-relat...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
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