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American Association of Neurological Surgeons, May 2-6, 2009

Last Updated: May 11, 2009.

American Association of Neurological Surgeons 77th Annual Meeting

The American Association of Neurological Surgeons' 77th Annual Meeting took place May 2 to 6 in San Diego and attracted about 7,000 attendees from around the world, including 3,000 medical professionals. The Scientific Program included 17 general scientific sessions, three plenary sessions, an International Symposium, and 189 oral abstract presentations addressing recent advances in neurological surgery.

"This conference demonstrates the breadth of research being performed by neurological surgeons across the country," said public relations committee member John Ratliff, M.D., of Thomas Jefferson University in Philadelphia. "We presented fantastic research in traumatic brain injury, an important paper in spinal surgery, and a number of good papers for the treatment of brain tumors, hyperhydrosis, and hydrocephalus."

Roukoz B. Chamoun, M.D., of the Baylor College of Medicine in Houston, and colleagues used cerebral microdialysis to measure glutamate levels in 165 patients with severe traumatic brain injury. They found that a lower initial glutamate level was associated with decreased mortality (18 versus 30.3 percent) and that patients whose glutamate levels normalized during the first 120 hours of monitoring were more likely to achieve a good six-month functional outcome (41.2 versus 20.7 percent).

"Unveiling the molecular basis of traumatic brain injury is crucial for a better understanding of this condition, potentially leading to an improvement in the treatment and outcome of these patients," Chamoun said in a statement.

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"A good article from the University of California in San Francisco showed how a less invasive treatment can preserve hearing and facial function in patients with vestibular schwannomas," Ratliff said.

During the study, which received this year's Leksell Radiosurgery Award, Isaac Yang, M.D., and colleagues analyzed data on 6,438 patients who were treated with Gamma Knife® radiosurgery. Compared to higher-dose radiosurgery (above 13 Gray), they found that lower-dose radiosurgery was associated with better rates of hearing preservation (61 versus 50 percent) and improved facial nerve function (98 versus 95 percent).

"Our results from a large sample size confirm what many investigators have shown previously with smaller single institution studies," a co-author said in a statement.

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"A great article showed that surgical decompression is associated with fantastic results in patients with cervical spondylotic myelopathy," Ratliff said. "This is one of the first times a multi-center critical prospective study has demonstrated what clinicians have known all along -- that surgical treatment is efficacious."

Michael G. Fehlings, M.D., of the University of Toronto in Canada, and colleagues studied one-year outcomes in 294 patients (mean age of 57 years) who received anterior surgery (59 percent), posterior surgery (36 percent), or a combined "360" approach (6 percent). They observed significant improvements in all outcome parameters, including modified Japanese Orthopedic Association Scale, Neck Disability Index, Nurick score, quantitative assessments of walking speed, SF36 quality of life assessment, and complications.

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Parham Yashar, M.D., of Children's Hospital Los Angeles, presented data on 105 children with hydrocephalus (mean age of 13.2 years) who received ventriculopleural shunts over a 30-year period. They found that shunt placement was associated with no complications in 45.7 percent of the children but that 12.4 percent of patients developed a symptomatic pleural effusion.

"Given that nearly half of the patients in this series did not develop any complications from placement of ventriculopleural shunts, we believe that placement of these shunts for the treatment of hydrocephalus is a safe alternative to ventricuperitioneal and ventriculoatrial shunts in children age 8 and older," Yashar said in a statement.

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Ratliff also applauded the results of study by Curtis A. Dickman, M.D., of the Barrow Neurological Institute in Phoenix, and colleagues showing that a minimally invasive surgical technique benefits teens with hyperhydrosis. "For teens, excessive sweating is a big deal," he said. "It's very embarrassing and socially limiting. For them, this is exciting news."

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AANS: Surgical Technique May Ease Post-Herpetic Neuralgia

THURSDAY, May 7 (HealthDay News) -- Patients with severe post-herpetic neuralgia who do not respond to conventional treatment or cannot tolerate the side effects may benefit from surgical implantation of a mechanical pump that delivers narcotic medications directly to the spinal sac, according to research presented this week at the annual meeting of the American Association of Neurological Surgeons, held from May 2 to 6 in San Diego.

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AANS: Brain Stimulation Helpful in Treatment-Resistant Disorders

WEDNESDAY, May 6 (HealthDay News) -- Brain stimulation may be an effective treatment for treatment-resistant major depressive disorder and treatment-resistant primary generalized dystonia, according to two studies presented this week at the annual meeting of the American Association of Neurological Surgeons, held from May 2 to 6 in San Diego.

Abstract - Eskander
Abstract - Mehrkens
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AANS: Treatment Techniques Developed for Gliomas

MONDAY, May 4 (HealthDay News) -- Two novel drug-delivery techniques show promise in the treatment of malignant gliomas, according to two studies presented at the annual meeting of the American Association of Neurological Surgeons, held from May 2 to 6 in San Diego.

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