Prevention of valve reversal in lumboperitoneal shunt surgery: Effectiveness of above-the-superficial-fascia placement using an inline shunt passer.

Background: Valve reversal following lumboperitoneal shunt (LPS) surgery can lead to valve mis adjustment or failure, potentially causing complications such as overdrainage and chronic subdural hematoma. While proper fixation and placement depth are considered important for prevention, effective strategies have not been well established.

Methods: We retrospectively analyzed 30 LPS procedures performed at our institution from January 2021 to December 2024.

Endoscopic Hematoma Evacuation for Spontaneous Acute Subdural Hematoma: The Role of Preoperative Imaging.

Spontaneous acute subdural hematoma (SDH) is a rare but potentially life-threatening condition. We present the case of a 73-year-old man with spontaneous acute SDH in which a computed tomography angiography (CTA) demonstrated contrast extravasation from a cortical artery. The patient was successfully treated with endoscopic hematoma evacuation via a small craniotomy, minimizing surgical invasiveness.

Rare Complications of Lumboperitoneal Shunts: Abdominal Cerebrospinal Fluid Pseudocysts in Adults.

Abdominal cerebrospinal fluid (CSF) pseudocysts are rare complications of shunt surgery, predominantly reported in pediatric patients undergoing a ventriculoperitoneal (VP) shunt. In contrast, their occurrence following lumboperitoneal (LP) shunt is exceptionally uncommon. We report the case of a 76-year-old woman who presented with recurrent symptoms, including gait disturbance and cognitive decline, approximately three years after undergoing LP shunt placement for idiopathic normal pressure hydrocephalus.

Efficacy and Safety of the Lateral Abdominal Approach for Lumboperitoneal Shunts in the Post-surgical Abdomen.

Background: Patients with previous abdominal surgeries are often considered unsuitable for lumboperitoneal (LP) or ventriculoperitoneal shunt placement due to the potential risk of peritoneal adhesions. This study evaluates the safety and efficacy of the lateral abdominal approach for LP shunt insertion in such patients.

Methods: A retrospective analysis was performed on 21 patients who underwent LP shunt placement for idiopathic normal pressure hydrocephalus (iNPH) via the lateral abdominal approach at our institution between January 2021 and December 2022.

Reversible Cerebral Vasoconstriction Syndrome without Headache.

A 49-year-old woman with a family history of Moyamoya disease presented with sudden onset of right hemiparesis without headache. Magnetic resonance imaging (MRI) of the head revealed a cerebral infarct in the left corona radiata, and magnetic resonance angiography (MRA) revealed severe stenosis of the bilateral internal carotid, middle, anterior, and posterior cerebral arteries. Antithrombotic therapy improved her symptoms.

Distinguishing Cerebral Infarction With Neck Pain and Hemiparesis From Cervical Spinal Epidural Hematoma Without MRI: A Case Report.

In patients presenting neck pain and hemiparesis, differentiation between cerebral infarction and cervical spinal epidural hematoma is vital yet challenging, particularly when magnetic resonance imaging (MRI) is not feasible. A 59-year-old woman presented with a sudden onset of left-sided hemiparesis and neck pain. MRI was contraindicated because the patient underwent embolization in childhood.

Successful Management of Acute Subdural Hematoma in Deep Brain Stimulation Patient: A Case Report and Literature Review.

Deep brain stimulation (DBS) has emerged as an important therapeutic option for several movement disorders; however, the management of acute complications, such as acute subdural hematoma (ASDH), remains challenging. This is the case of a 71-year-old woman with Parkinson's disease who developed ASDH 12 years after bilateral DBS placement. On admission with altered consciousness, imaging revealed significant displacement of the DBS electrodes because of the hematoma.

Pallidal deep brain stimulation for patients with myoclonus-dystonia without SGCE mutations.

Background: Pallidal deep brain stimulation (GPi-DBS) is effective for treating myoclonus and dystonia caused by SGCE mutations (DYT-SGCE, DYT11). However, it is unknown whether GPi-DBS is effective for the treatment of myoclonus-dystonia which is not associated with the SGCE gene mutations. In this study, we investigated the efficacy of GPi-DBS in treating myoclonus-dystonia in SGCE mutation-negative cases.

Long-term safety of spinal cord stimulation systems in a prospective, global registry of patients with chronic pain.

The availability of long-term (>2 years) safety outcomes of spinal cord stimulation (SCS) remains limited. We evaluated safety in a global SCS registry for chronic pain. Participants were prospectively enrolled globally at 79 implanting centers and followed out to 3 years after device implantation.

Sacral myolipoma with involuntary contraction causing tethered cord syndrome: illustrative case.

Background: Spinal lipomas sometimes involve various ectopic tissues originating from the ectoderm, mesoderm, and endoderm in the process of morphological development.

Observations: A 29-year-old male patient with myolipoma of the conus medullaris at the S2 and S3 levels was described. The unusual finding, involuntary muscle contraction, was presented in an operative video and a literature review.

Vagus Nerve Stimulation with Mild Stimulation Intensity Exerts Anti-Inflammatory and Neuroprotective Effects in Parkinson's Disease Model Rats.

Background: The major surgical treatment for Parkinson's disease (PD) is deep brain stimulation (DBS), but a less invasive treatment is desired. Vagus nerve stimulation (VNS) is a relatively safe treatment without cerebral invasiveness. In this study, we developed a wireless controllable electrical stimulator to examine the efficacy of VNS on PD model rats.

Single arm prospective multicenter case series on the use of burst stimulation to improve pain and motor symptoms in Parkinson's disease.

Background: In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson's Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS).

Methods: Fifteen patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst stimulation (40 Hz, 500 Hz, 1000 μs), or cycle mode (on time of 10-15 s, off time of 15-30 s) with Burst (40 Hz, 500 Hz, 1000 μs).

Identification of Somatotopic Organization and Optimal Stimulation Site Within the Subthalamic Nucleus for Parkinson's Disease.

Background: Details of the somatotopy within the subthalamic nucleus (STN) are still poorly understood; however, the STN is a common target of deep brain stimulation (DBS) for Parkinson disease.

Objective: To examine somatotopic organization within the STN and identify optimal stimulation sites from 77 surgical cases with microelectrode recording.

Methods: STN-DBS was performed for 77 patients with Parkinson disease between 2010 and 2014.

Characteristics and prognostic factors of Parkinson's disease patients with abnormal postures subjected to subthalamic nucleus deep brain stimulation.

Objective: In Parkinson's disease (PD), abnormal postures are often accompanied, which interfere with rehabilitation and subsequent functional recovery. This study investigated the relationship between clinical characteristics and improvement in abnormal postures of PD patients who received subthalamic nucleus deep brain stimulation (STN-DBS).

Methods: Seventy-four PD patients were included in this study.

Efficacy of Dural Sealant System for Preventing Brain Shift and Improving Accuracy in Deep Brain Stimulation Surgery.

The success of deep brain stimulation (DBS) depends heavily on surgical accuracy, and brain shift is recognized as a significant factor influencing accuracy. We investigated the factors associated with surgical accuracy and showed the effectiveness of a dural sealant system for preventing brain shift in 32 consecutive cases receiving DBS. Thirty-two patients receiving DBS between March 2014 and May 2015 were included in this study.

Complex observation of scalp fast (40-150 Hz) oscillations in West syndrome and related disorders with structural brain pathology.

We investigated the relationship between the scalp distribution of fast (40-150 Hz) oscillations (FOs) and epileptogenic lesions in West syndrome (WS) and related disorders. Subjects were 9 pediatric patients with surgically confirmed structural epileptogenic pathology (age at initial electroencephalogram [EEG] recording: mean 7.1 months, range 1-22 months).

The Factors Affecting the Difficulty of Percutaneous Cylindrical Electrode Placement for Spinal Cord Stimulation.

Objective: Optimal placement of electrodes is important for spinal cord stimulation. Factors affecting the difficulty of percutaneous electrode placement are not well known. In this study, we retrospectively evaluated the factors affecting the difficulty of percutaneous electrode placement.