In Parkinson's disease dopaminergic medication and deep brain stimulation of the subthalamic nucleus increase motor, but not reflection and cognitive impulsivity.

Background: Parkinson's disease is associated with increased impulsivity, which can be divided into several domains: motor (consisting of proactive and reactive subdomains), reflection, and cognitive impulsivity. Evidence suggests that both dopaminergic medication and subthalamic nucleus deep brain stimulation can affect impulsivity. Therefore, we set out to investigate the effects of dopaminergic medication and subthalamic nucleus deep brain stimulation on motor, reflection, and cognitive impulsivity in Parkinson's disease patients.

COVID-19 and Surgical Practice in Slovenia: Managing the Crisis in Neurosurgery during the COVID-19 Pandemic.

Worldwide, the novel coronavirus disease 2019 (COVID-19) has become a significant threat to global health. Worldwide, COVID-19 has affected the health service also in Slovenia. During this time, neurosurgery is facing difficulties in its service, both in emergency and elective surgeries.

Twenty years of intrathecal baclofen therapy in Slovenia: a retrospective single-center analysis of complications.

Since the first implantation in July 2001, the intrathecal baclofen (ITB) therapy for patients with generalized spasticity has been used in Slovenia for 20 years. The aim of this retrospective study was to evaluate the rates of different complications, especially if catheter-related complications were less frequent after the introduction of the coated catheter type in February 2013, and the potential correlation between higher baclofen doses and the incidence of complications. We retrospectively collected data from all patients in the registry during the period from 3 July 2001 to 31 December 2021.

Long-term effect of bilateral STN-DBS on non-motor symptoms in Parkinson's disease: A four-year observational, prospective study.

Background: Several studies have shown beneficial effects of bilateral stimulation of the subthalamic nucleus (STN-DBS) on motor as well as on non-motor symptoms (NMS) up to 36 months post-surgery in advanced Parkinson's disease (PD) patients. We set to explore the long-term effect of STN-DBS on NMS in a four-year follow-up, prospective, observational study.

Methods: Forty patients were enrolled and assessed at baseline.

Early medical rehabilitation after neurosurgical treatment of malignant brain tumours in Slovenia.

Background: The number of patients with malignant brain tumours is on the rise, but due to the novel treatment methods the survival rates are higher. Despite increased survival the consequences of tumour properties and treatment can have a significant negative effect on the patients' quality of life. Providing timely and appropriate rehabilitation interventions is an important aspect of patient treatment and should be started immediately after surgery.

Early outcome in endoscopic extended endonasal approach for removal of supradiaphragmatic craniopharyngiomas: a case series and a comprehensive review.

Background: The choice of endoscopic expanded endonasal approach introduces the possibility of improved gross total resection of craniopharyngioma while minimizing surgical morbidity in a significant subset of patients.

Methods: From our trans-sphenoidal surgical series of 331 cases, we retrospectively reviewed visual, endocrine and neuro-cognitive outcomes in the first consecutive eight patients (median age 63 years; range 47-73 years) with newly diagnosed supradiaphragmatic craniopharyngioma (median tumour height 23 mm; range 15-34 mm), removed by expanded endonasal approach (median follow-up 27 months; range 10-69 months). Gross total resection was attempted in all patients.

Cortical potentials after electrical intraneural stimulation of the optic nerve during orbital enucleation.

Background: The aim of this study was to present cortical potentials after electrical intraneural stimulation of the optic nerve during orbital enucleation due to malignant melanoma of the choroid or the ciliary body. These cortical potentials were related to cortical potentials after electrical epidural stimulation of the optic nerve, recorded during non-manipulative phases of neurosurgery for central skull base tumors.

Methods: Cortical potentials were recorded with surface occipital electrode (Oz) in six patients undergoing orbital enucleation under total intravenous anesthesia.

Intraoperative monitoring of the visual function using cortical potentials after electrical epidural stimulation of the optic nerve.

Background: Central skull base meningiomas commonly present with visual deficit, and their removal often leads to improvement of visual function. However, the incidence of postoperative visual deterioration has been reported to be up to 10%. Intraoperative monitoring using flash visual evoked potential has only recently been used with success.

Optic nerve potentials and cortical potentials after stimulation of the anterior visual pathway during neurosurgery.

The aim was to present cortical potentials after intraoperative electrical epidural stimulation of the optic nerve (ON) in individuals with normal preoperative vision. Optic nerve potentials after flash and electrical stimulation were additionally recorded. Contact electrodes on ON and occiput were used for monopolar recording of optic nerve potentials and cortical potentials, respectively.

Direct epidural electrical stimulation of the optic nerve: a new method for intraoperative assessment of function.

Intraoperative visual system monitoring of lesions with a close relationship to the optic apparatus by using light flashes reportedly is difficult to perform, and the results are too unreliable to interpret. The authors used direct epidural electrical stimulation of the optic nerve (ON) during surgery instead of light flashes. Four patients were included in this feasibility study.

Electrophysiologic and clinical data support the use of dorsal root entry zone myelotomy in syringosubarachnoid shunting for syringomyelia.

Background: The objectives of this study were to correlate preoperative changes in SEPs with clinical sensory dysfunction and to establish their importance in planning the microsurgical approach, either by DM myelotomy or by DREZ myelotomy, for patients with syringomyelia.

Methods: In addition to conducting clinical sensory examination, we evaluated the N13 potential after median nerve stimulation and CPs after tibial nerve stimulation intraoperatively before performing myelotomy on patients with syringomyelia (N = 14).

Results: Eleven patients with intact DS presented with unilateral PTD, and 9 had distressing unilateral dermatomal pain.

Continuous wavelet transform of laser-Doppler signals from facial microcirculation reveals vasomotion asymmetry.

Facial laser Doppler flux (FLDF) consists of a mean value and complex oscillatory components called vasomotion. Vasomotion can be expressed as spectral amplitudes (SA) after the application of continuous wavelet transform. Vasomotion is influenced by cardiac activity (frequency interval I), respiration (interval II), intrinsic myogenic activity (interval III), neural mechanisms (interval IV) and endothelial mechanisms (intervals V and VI).

T1-nerve root neuroma presenting with apical mass and Horner's syndrome.

Background: The appearance of dumbbell neuroma of the first thoracic root is extremely rare. The extradural component of a T1-dumbbell neuroma may present as an apical mass. The diagnosis of hand weakness is complex and may be delayed in T1-neuroma because of absence of the palpable cervical mass.

H wave and spinal root potentials in neuromonitoring of S1 root function during evacuation of herniated disc: preliminary results.

Aim: To determine the changes in the tibial H reflex and spinal nerve root potentials (SRPs) of the S1 root during posterior discectomy and the effects of surgical manipulation.

Methods: Tibial H reflex responses (M and H waves) were intermittently recorded from the soleus muscle by surface electrodes during different stages of surgery in 5 patients with S1 radiculopathy. All patients had Achilles reflex preserved bilateraly and no paresis on manual strength testing preoperatively.

Laser-Doppler flowmetry and Horner's syndrome in patients with complete unilateral damage to the parasellar sympathetic fibers during cavernous sinus surgery.

Aim: To determine ocular, sudomotor, and vasomotor components of Horner's syndrome resulting from complete unilateral intraoperative damage to the parasellar sympathetic fibers during cavernous sinus surgery.

Methods: Complete damage to the parasellar sympathetic fibers was found in four patients operated for central skull base lesions. Pupilometry, eyelid fissure measurement, Hertel's exophthalmometry, starch iodine sweat test, and laser-Doppler perfusion assessment of bilaterally symmetrical forehead and cheek areas were performed.

Left-right asymmetry of the facial microvascular control.

Facial blood flow and temperature were significantly higher on the right side of the forehead compared to the left. This asymmetry implies that the hemispheric autonomic control of the face differs and could influence the expression of emotion.