Assessing parkinsonism & cerebellar dysfunction with spiral & line drawings.

Background And Purpose: Recognising neurological diseases is challenging without accurate diagnostic tools. Therefore, many approaches have been taken to recognise and evaluate these diseases through speech, movement, or drawing modalities.The purpose of the study is to compare the recognition of Parkinson’s and cerebellar symptoms using spiral and line drawings recorded from the same subjects.

Recognition analysis of spiral and straight-line drawings in tremor assessment.

Objectives: No standard, objective diagnostic procedure exists for most neurological diseases causing tremors. Therefore, drawing tests have been widely analyzed to support diagnostic procedures. In this study, we examine the comparison of Archimedean spiral and line drawings, the possibilities of their joint application, and the relevance of displaying pressure on the drawings to recognize Parkinsonism and cerebellar dysfunction.

Removal Notice to 'Neurosurgical Steps and Lessons Learned in Final Separation of Three-Years-Old Craniopagus Twins' [World Neurosurgery (2022) 18924].

This article has been removed: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/locate/withdrawalpolicy).

Neurosurgical Steps and Lessons Learned in Final Separation of 3-Year-Old Craniopagus Twins.

The only published paper describing the separation of the conjoined twins did not describe the novel steps and techniques of the microsurgery part, which lasted 26 hours. That paper did not include the neurosurgical video, either. The massive intracerebral hemorrhage that occurred on postoperative day 33 was not reported, and its potential causes have not been scrutinized.

Impaired sequential and partially compensated probabilistic skill learning in Parkinson's disease.

The striatal dopaminergic dysfunction in Parkinson's disease (PD) has been associated with deficits in skill learning in numerous studies, but some of the findings remain controversial. Our aim was to explore the generality of the learning deficit using two widely reported skill learning tasks in the same group of Parkinson's patients. Thirty-four patients with PD (mean age: 62.

The effect of deep brain stimulation of the subthalamic nucleus on executive functions: impaired verbal fluency and intact updating, planning and conflict resolution in Parkinson's disease.

Although the improvement of motor symptoms in Parkinson's disease (PD) after deep brain stimulation (DBS) of the subthalamic nucleus (STN) is well documented, there are open questions regarding its impact on cognitive functions. The aim of this study was to assess the effect of bilateral DBS of the STN on executive functions in PD patients using a DBS wait-listed PD control group. Ten PD patients with DBS implantation (DBS group) and ten PD wait-listed patients (Clinical control group) participated in the study.

Effect of subthalamic stimulation on distal and proximal upper limb movements in Parkinson's disease.

Introduction: A different innervation pattern of proximal and distal muscles from the contra- and ipsilateral motor circuits raises the question as to whether bilateral, contra- and ipsilateral subthalamic stimulation may have different effects on the distal and proximal movements of the upper limb. To answer this question, we performed kinematic analyzes in patients with Parkinson's disease.

Methods: Twenty-eight Parkinsonian patients treated by bilateral subthalamic stimulation were examined with an age-matched control group of 28 healthy subjects.

Positioning Accuracy in Otosurgery Measured with Optical Tracking.

Objectives: To assess positioning accuracy in otosurgery and to test the impact of the two-handed instrument holding technique and the instrument support technique on surgical precision. To test an otologic training model with optical tracking.

Study Design: In total, 14 ENT surgeons in the same department with different levels of surgical experience performed static and dynamic tasks with otologic microinstruments under simulated otosurgical conditions.

Modelling pathology from autolog fresh cadaver organs as a novel concept in neurosurgical training.

Background: The aim of neurosurgical cadaver training for residents and fellows is not only to obtain a high level of skills, but also to keep the number of complications during the learning curve as low as possible. To move this process forward, we have worked out a novel method in further training.

Methods: Tumours can be modelled from the autolog organs.

Straight needle with fingertip support technique reduces exclusion time during bypass (in vitro, in vivo animal study): a technical note.

Background: The duration of exclusion time of recipient artery is an important factor in bypass surgery of cerebral revascularization. The longest period of exclusion is the suturing time. The fingertip support technique (first published in 2006) reduced the physiological tremor to speed up this extra-precise microsurgical procedure.

Target identification for stereotactic thalamotomy using diffusion tractography.

Background: Stereotactic targets for thalamotomy are usually derived from population-based coordinates. Individual anatomy is used only to scale the coordinates based on the location of some internal guide points. While on conventional MR imaging the thalamic nuclei are indistinguishable, recently it has become possible to identify individual thalamic nuclei using different connectivity profiles, as defined by MR diffusion tractography.

The importance of very early decompressive craniectomy as a prevention to avoid the sudden increase of intracranial pressure in children with severe traumatic brain swelling (retrospective case series).

Purpose: The purpose of the retrospective case series of eight consecutive patients is to call our attention to the optimal timing of decompressive craniectomy (DC) in children.

Method: We report the outcomes of eight children under the age of 12 with severe head injuries. DC was performed at different intracranial pressure (ICP; 20 and 25 mmHg) levels.

In vitro and in vivo surgical and MRI evidence to clarify the effectiveness of the vascular tunnel technique in the course of decompressive craniectomy.

Objective: To demonstrate the efficacy of a vascular protection technique during decompressive craniectomy (DC) which can reduce the risk of secondary venous infarction due to the blocking pressure for venous outflow through bridging veins.

Method: The observation was carried out In vitro (cadaver) and in vivo (surgery and magnetic resonance imaging) in order to verify the durability of the vascular tunnel.

Results: in vivo observation proved the durability of vascular tunnel even 2 months later.

Effectiveness of unilateral pallidotomy for meige syndrome confirmed by motion analysis.

Background: We report the case of a 64-year-old woman with bilateral manifestation of Meige syndrome (MS) successfully treated with left-side unilateral ventroposterolateral pallidotomy.

Methods: Symptoms were evaluated according to the Burke-Fahn-Marsden dystonia rating scale. Head tremor, blepharospasm and orofacial dyskinesia were measured with an infrared, video-based, computerized, real-time passive marker-based analyzer of motions (RTPAM).

Voice acoustic changes during bilateral subthalamic stimulation in patients with Parkinson's disease.

Objectives: The purpose of this study was to investigate the effects of bilateral subthalamic nucleus deep brain stimulation on the phonation of patients with Parkinson's disease in three drug-free conditions: (1) stimulation off, (2) with clinically optimised stimulation parameters, and (3) subthreshold overstimulation, in order to detect differences following voice analysis.

Patients And Methods: Conversational speech and sustained vowel sounds /a/, /i/, /o/, /u/ and high /i/ were recorded from 22 PD patients. Perceptual analysis, perturbation jitter, shimmer, noise-to-harmonics ratio, and nonlinear dynamic analysis (NDA) with detrended fluctuation analysis and recurrence period density entropy were measured and compared to the above conditions.

Deep brain stimulation for treatment refractory obsessive-compulsive disorder--a case report.

In the past 30 years it has been a great development in the unders-anding and therapy of obsessive-compulsive disorder. Adequate pharmaco- and cognitive-behavior therapies reduce the symptoms in 40-60% of patients, so a remarkable portion of patients still remains refractory to conventional treatment. Neurosurgery--with it's reversible and irreversible techniques--brought a breakthrough in the therapy of treatment refractory patients.

[Movement analyzing devices for assessing the actual state of patients with movement disorders].

Movement analysis gives valuable information on the actual state of patients. Based on it, the early diagnosis and objective assessment of the progress of several diseases can be helped. Our research work has been focused on developing clinically applicable movement analyzing devices.

[Application of robot hand technique in the course of microneurosurgical operations].

Introduction: The aim of this study was to determine whether the new robot hand technique can help to avoid the complication in the course of high precise microneurosurgical operations.

Methods: The physical efficacy was measured by tremorometry. The comparative study of the incidence of complications measured the clinical efficacy.

Pallidal deep brain stimulation and L-dopa effect on PET motor activation in advanced Parkinson's disease.

BACKGROUND AND PURPOSE The antiakinetic effect of internal Globus pallidus deep brain stimulation (Gpi-DBS) in Parkinson's disease is not clear and not either how this effect is modulated by L-dopa. METHODS Left Gpi-DBS and/or L-dopa effect was studied with auditory paced right-handed sequential movements on (15)O-butanol positron emission tomography (PET) in five patients. Rest and for conditions during movements (DBS off/L-dopa off; DBS on/L-dopa off; DBS off/L-dopa on; DBS on/L-dopa on) were compared with statistical parametric mapping.

Early experiences with a novel (robot hand) technique in the course of microneurosurgery.

Background: The physiologic tremor may cause difficulties in microsurgery, in spite of using armrest. The new (robot hand) technique consists of the I-III finger support, which holds the instruments on Bethlehem (ANDAN BT, Budapest, Hungary) bridge above the operation area, which reduces the tremor at the end of the instruments.

Methods: Exact measurement of tremor reduction was performed.

[125-I brachytherapy of pineal parenchymal tumours in two patients and review of the literature].

Introduction: Pineal parenchymal tumours make up 0.3% of all brain tumours. Stereotactic biopsy has by now become an indispensable method to detect these tumours and it can be safely performed.