American Association of Neurological Surgeons, April 5-9Last Updated: April 10, 2014.
The annual meeting of the American Association of Neurological Surgeons was held from April 5 to 9 in San Francisco and attracted more than 7,000 participants from around the world, including neurosurgeons, neurosurgical residents, medical students, neuroscience nurses, clinical specialists, physician assistants, allied health professionals, and others interested in neurological surgery. The conference highlighted recent advances in neurological surgery, with presentations focusing on the prevention, management, and rehabilitation of nervous system disorders, including disorders of the spinal column, spinal cord, brain, and peripheral nerves.
In one study, Anthony L. Asher, M.D., of Carolina Neurosurgery & Spine Associates in Charlotte, N.C., and colleagues aimed to identify predictors of 12-month surgical outcomes for lumbar disc herniation and spondylolisthesis using an outcomes database.
"Most patients report initial outcome scores that reflect significant baseline disability. Second, patients, on average, report major sustained improvements in disability, pain, quality of life, and return to work across all diagnoses and all surgical methods examined. Additionally, most patients are satisfied with care and over 80 percent state that they would have the same procedure again," said Asher. "Not surprisingly, some patients do not improve. About 18 percent of all patients report they wouldn't have surgery again. Twelve percent don't report improvement in important patient-specific factors such as disability. Additionally, although overall perioperative morbidity is low, meaningful numbers of patients require rehospitalization within 90 days of surgery."
According to Asher, the striking and novel finding in these data is the tremendous variability in the magnitude of treatment response among individual patients. This variability is observed at all time points and for all diagnoses, all procedures, all centers, and all reported outcomes.
"This pronounced individual patient variability represents perhaps our greatest opportunity to improve lumbar surgical spine care outcomes, by improving and refining the role of predictively valid patient selection for surgery," said Asher. "In other words, the best way to improve lumbar spine surgical outcomes is to avoid operating on patients destined for poor outcomes."
In another study, Jan Coburger, M.D., of the University of Ulm in Germany, and colleagues found that U.S. Food and Drug Administration-approved 5 aminolevulinic-acid (5-ALA) fluorescence is more sensitive in tumor (glioblastoma multiforme) detection than the contrast enhancement of intraoperative magnetic resonance imaging (MRI).
"This is a new finding since it was postulated before that 5-ALA and contrast enhancement show the same," said Coburger. "A practical conclusion is that a combination of the fluorescence dye and an intraoperative MRI seems to be the ideal surgical approach to malignant brain tumors."
Sheng-Tzung Tsai, M.D., of the Tzu-Chi General Hospital in Hualien, Taiwan, and colleagues found that intraventricular β-amyloid infusion in rats impaired spatial memory and decreased dendritic spine densities on medial prefrontal cortical and hippocampal CA1 pyramidal neurons where both areas involves cognitive circuit. The investigators also found that intralaminar thalamic deep brain stimulation (ILN-DBS) ameliorated the spatial memory impairment in rats infused with β-amyloid. In addition, decrease of structural neuronal plasticity by β-amyloid could be restored after ILN-DBS.
"Dementia remains the most prevalent and intimidating neurodegenerative disease. Recently, entorhinal cortex and fornix deep brain stimulation have been reported to improve cognition in humans," said Tsai. "Based on our results of the study, we hope we can identify another deep brain stimulation target within the human brain that may help patients with cognitive impairment."
AANS: Subclinical Head Impact Still Impacts Brain
THURSDAY, April 10, 2014 (HealthDay News) -- A single season of football can lead to measurable brain changes even with subclinical contact, according to a study presented at the annual meeting of the American Association of Neurological Surgeons, held from April 5 to 9 in San Francisco.
AANS: Stem Cells May Aid Stroke Patients
THURSDAY, April 10, 2014 (HealthDay News) -- Intraparenchymal transplantation of human modified bone marrow-derived stromal cells in chronic stroke patients is safe, feasible, and results in improved neurologic function, according to a study presented at the annual meeting of the American Association of Neurological Surgeons, held from April 5 to 9 in San Francisco.
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