Immunobiology of spinal cord injuries and potential therapeutic approaches.

The incidence of spinal cord injuries (SCI) is high every year. As the spinal cord is the highway that allows for the brain to control the rest of the body, spinal cord injuries greatly impact the quality of life of the patients. The SCI include the primary response consisting of the initial accident-induced damage and the secondary response that is characterized by damage due to inflammation and biological responses.

The danger zone: Systematic review of the role of HMGB1 danger signalling in traumatic brain injury.

Background: Traumatic brain injuries (TBI) are associated with complex inflammatory pathways that lead to the development of secondary injuries such as cerebral ischaemia, elevated intracranial pressure and cognitive deficits. The association between intracellular danger signalling involving nuclear chromatin-binding factor, high mobility group box-1 (HMGB1) and inflammatory pathways following TBI has not yet been fully understood.

Primary Objective: To comprehensively review the available literature regarding the potential diagnostic, prognostic and therapeutic use of HMGB1 in TBI.

Hippocampal Transections for Epilepsy.

Multiple hippocampal transection (MHT) is a novel surgical procedure that serves to disrupt seizure propagation fibers within the hippocampus without impairing verbal memory or the loss of stem cells. Given the paucity of literature regarding the utility and long-term outcome of MHT, a review is presented of the current literature to support the utility of this procedure in the treatment of intractable temporal lobe epilepsy. Long-term outcome analysis of this technique has been reported by 2 independent groups.

Long term follow-up after multiple hippocampal transection (MHT).

Purpose: Multiple hippocampal transection (MHT) is a new surgical procedure which disrupts seizure propagation within the hippocampus without impairing verbal memory or the loss of stem cells. Since there are very few papers on this procedure, the authors are presenting their long term results to increase the database on this procedure.

Method: Long term outcome in 15 consecutive patients who had MHT for unlilateral temporal lobe epilepsy, had intra-operative electro-corticography (ECoG) and have a minimum follow-up of at least 2 years is presented.

Intraoperative image fusion to ascertain adequate lead placement.

Background: In order to view the position of the deep brain stimulator (DBS) lead in relation to the stereotactic target on 3-tesla magnetic resonance (3T-MR) images prior to the conclusion of the procedure, intraoperative postimplantation computed tomography (CT) images were fused with preoperative 3T-MR images. The method to do this is described and discussed in this paper.

Methods: Over the last year, this method was used for 8 procedures: 6 for subthalamic nucleus and 2 for ventral-intermediate nucleus of the thalamus.

Nonresective hippocampal surgery for epilepsy.

Introduction: Clinical experience with a new surgical procedure called multiple hippocampal transections is described. In this procedure, seizure circuits within the hippocampus are disrupted by making multiple cuts parallel to the hippocampal digitations; while the vertical functional fibers are preserved.

Methods: Ten patients with temporal lobe epilepsy are described.

A modified stereotactic frame as an instrument holder for frameless stereotaxis: Technical note.

Background: In order to improve the targeting capability and trajectory planning and provide a more secure probe-holding system, a simple method to use a stereotactic frame as an instrument holder for the frameless stereotactic system was devised.

Methods: A modified stereotactic frame and BrainLab vector vision neuronavigation sys¬tem were used together. The patient was placed in the stereotactic head-holder to which a reference array of the neuronavigation system was attached.

Computed tomography-guided vertebroplasty using a stereotactic guidance system (stereo-guide).

Background: In order to make it easy to perform computed tomography (CT)-guided vertebroplasty a stereotactic guidance system called the "stereo-guide" was designed. A method to perform CT-guided vertebroplasty using this system is described.

Methods: The device is a rectangular flat plastic block.

Stereotactic approach to the trigeminal ganglion using a stereotactic frame and intraoperative computed tomography scans: technical note.

Objective: In this paper, a technique to place a probe at the trigeminal ganglion using a stereotactic frame and intraoperative computed tomography (CT) scans is described.

Method: The procedure is performed on the CT table using a stereotactic frame. After the coordinates have been obtained and then adjusted, the target is probed using the frame.

Direct anatomical localization of the subthalamic nucleus on CT with comparison to Schaltenbrand-Wahren atlas.

Stimulation of the subthalamic nucleus (STN) has become an accepted treatment for motor symptoms of Parkinson's disease. Generally, localization of the target is based on stereotactic atlas coordinates and magnetic resonance (MR) images. In this paper a method of direct anatomical localization of the STN on computed tomography (CT) images is described and compared with the Schaltenbrand-Wahren atlas.

Improving the lives of patients with medically refractory epilepsy by electrical stimulation of the nervous system.

Vagal nerve stimulation proved effective in animal models of epilepsy, and in open and double-blinded trials, in over 450 patients. Seizure reduction improved for at least 2 years. Almost 50% of treated patients achieve at least a 50% reduction in seizure frequency.

Is epilepsy surgery on both hemispheres effective?

Background: Patients with bilateral independent seizure foci are poor candidates for conventional resective epilepsy surgery. The authors have therefore used minimally invasive procedures to treat such patients. In this paper, the result of a large series of patients treated by this approach is examined to determine the effectiveness of this approach.

Single-unit artificial intervertebral disc.

Object: The authors describe a new type of artificial disc called a single-unit artificial disc (SUAD). It is a single-unit disc without components, and there is no fixation system with which to maintain it in the disc space. It is theorized that its shape, hardness, and surface consistency, together with the compressive force exerted by the body's axial load, should be adequate to maintain the position of the disc in the disc space.