The cerebrospinal fluid container is a device for storage of medicaments. By means of surgical operation, a ventricle catheter can be embedded in the ventricle of the brain. This safe and reliable device provides for neurosurgeons a new method of intracranical therapy and reestablishment of the circulating passage of the cerebrospinal fluid.
Brain Diseases ; surgery ; Catheters, Indwelling ; Cerebrospinal Fluid ; Cerebrospinal Fluid Shunts ; instrumentation ; Equipment Design ; Humans ; Neurosurgical Procedures ; instrumentation

Blocks of the ganglion impar are used to treat both malignant and benign causes of visceral and sympathetic pelvic and perineal pain. While conventionally done under fluoroscopic guidance, significant improvements in transducer technology in the past decade have piqued the interest and enthusiasm of interventional pain specialists toward ultrasound-guided performance. In the setting of a pandemic, it is important to ensure the efficacy of treatment as well as the safety of both patients and health care workers. This paper presents two patients who underwent two approaches of ultrasound-guided ganglion impar blocks in a tertiary government hospital in the Philippines during the COVID-19 pandemic.

Ultrasonography, Interventional ; Autonomic Nerve Block ; COVID-19

Several case reports suggest that neurosurgical operations can improve symptoms in patients with severe treatment-refractory obsessive-compulsive disorder (OCD). However, it is unclear which procedure is best and which may produce the most side-effects. We also review recent ethical issues related to the procedures. We review the literature on the efficacy and complications of frequently used neurosurgical procedures that are used to treat refractory OCD and related ethical issues. Since the vast majority of patients who underwent surgery were severely and chronically disabled, it is likely that these procedure were of assistance in alleviating some of their symptoms. It is currently impossible to determine which surgical procedure is the best for a particular patient. Since the psychosurgery is reported as effective in the area of human behavior and psychopathology, the indication for operation demand strict ethical process. Recent studies report that strict informed consent and the evaluation for competence to decide whether to get operation with free will should be taken so as to stress the autonomy of patients for the treatment. Despite a lack of controlled data and inconsistencies in the literature, it appears that when nonsurgical treatments have failed to improve OCD symptoms significantly in severely ill patients, at least partial relief can be obtained by some people with OCD by neurosurgery. Results of cumulative studies strongly support the need for continued research in this area.
Ethics* ; Humans ; Informed Consent ; Mental Competency ; Neurosurgery ; Neurosurgical Procedures ; Obsessive-Compulsive Disorder* ; Personal Autonomy ; Psychopathology ; Psychosurgery

No abstract available.
Hypophysectomy*

No abstract available.
Psychosurgery*

BACKGROUND: Video assisted thoracic sympathectomy or sympathicotomy is a safe and effective therapy for the treatment of palmar hyperhidrosis with immediate symptomatic imporvement. However the degree of satisfaction may diminish with time due to cmpensatory sweating or excessive hand dryness. Therefore by comparing and assessing the degree of symptomatic improvement or compensatory sweating following sympathectomy or sympathicotomy at various levels we aim to determine the optimal level of sympathetic nerve block which will result in minimal side effects and maximal benefit. MATERIAL AND METHOD: Among 194 patients having undergone video assisted thoracic sympathectomy or sympathicotomy between January 1996 and June 1999, 137 patients who responded to either telephone interview or questionnaire were included in the current study. The patients were divided into three groups. Group I(n=61) ; patients having undergone T2,3,4 sympathectomy group II(35) ; patients having undergone T2 sympathicotomy and group III(41) ; patients having undergone limited T2 sympathicotomy which consist of block of interganglionic neuronal fiber on the third rib. The parameters studied comprised of pre- and post-operative palmar temperature change treatment satisfaction the degree of compensatory sweating or discomfort from palmar dryness postoperative complication and changes in plantar sweating. RESULT: There was no difference in age and sex among the groups and the mean postoperative elevation in palmar temperature was 21.59degrees C without any differences among the groups. Patients expressing satisfaction were 65.6%, 62.9% and 90.24% in groups I, II and III, respectively(p<0.05) Moderate to severe compensatory sweating was present in 65.6% 51.4%, and 24.39%, in group I, II, and III, respectively (p<0.05) Slight but comfortable amount of palmar humidness was expressed in decreasing order group III(41.6%) group I(24.6%) and group II(5.7%) (p<0.05) Ineffectiveness or recurrence was present in 5patients in group I(8.2%) 1 patient in group II(2.9%) and none in group III. With regards to plantar sweating decrease in sweating was expressed in 43 patients(31.4%) while similar degree of sweating in 61 patients(44.5%) and increase in sweating in another 33 patinets(24.1%). CONCLUSION: Limited T2 sympathicotomy resection of the lower interganglionic neuronal fiber of the second sympathetic ganglion on the third rib showed immediate effect in palmar hyperhidrosis and caused lesser compensatory sweating and hand dryness.
Autonomic Nerve Block ; Ganglia, Sympathetic ; Hand ; Humans ; Hyperhidrosis* ; Interviews as Topic ; Neurons ; Postoperative Complications ; Surveys and Questionnaires ; Recurrence ; Ribs ; Sweat ; Sweating ; Sympathectomy

Endoscopy ; Humans ; Microsurgery ; Minimally Invasive Surgical Procedures ; Neurosurgical Procedures ; methods ; Stereotaxic Techniques

OBJECTIVETo review the advances in studies on renal denervation.

DATA SOURCESReferences concerning renal denervation and resistant hypertension cited in this review were collected from PubMed published in English and those of renal denervation devices from official websites of device manufacturers up to January 2014.

STUDY SELECTIONArticles with keywords "renal denervation" and "resistant hypertension" were selected.

RESULTSRenal and systemic sympathetic overactivity plays an important role in pathology of hypertension as well as other diseases characterized by sympathetic overactivity. Renal denervation is a new, catheter based procedure to reduce renal and systemic sympathetic overactivity by disruption of renal sympathetic efferent and afferent nerves through radiofrequency or ultrasound energy delivered to the endoluminal surface of both renal arteries. Although several studies have shown the efficacy and safety of renal denervation in the treatment of resistant hypertension and the potential benefit of the procedure in other diseases, Symplicity HTN 3 study, the most rigorous clinical trial of renal denervation to date, failed to meet its primary endpoint. The procedure also has other limitations such as the lack of long term, efficacy and safety data and the lack of the predictors for the blood pressure lowering response and nonresponse to the procedure. An overview of current renal denervation devices holding Conformité Européenne mark is also included in this review.

CONCLUSIONSRenal denervation is a promising therapeutic approach in the management of resistant hypertension and other diseases characterized by sympathetic overactivity. In its early stage of clinical application, the efficacy of the procedure is still controversial. Large scale, blind, randomized, controlled clinical trials are still necessary to address the limitations of the procedure.

Blood Pressure ; physiology ; Denervation ; methods ; Humans ; Hypertension ; Kidney ; innervation ; Neurosurgical Procedures ; Sympathetic Nervous System ; metabolism

More than 80% of cancer-related pain is pharmacologically controllable, whereas 10~20% of patients require interventional treatments. Neurolytic nerve block can play a major role in cancer pain treatment, and it has been proposed to prevent the development of pain and improve the quality of life of patients with cancer. If the pain is well localized and restricted to certain peripheral parts of the body, spinal peripheral or sympathetic nerve blocks may result in excellent therapeutic effects. Neurolytic sympathetic block, especially Celiac plexsus block (CPB) performed in earlier stages, is effective with successful long term results. However, selection of patients is critical for succeful outcomes. Neurolytic plexus block significantly improves the quality of life of patients and reduces abdominal and pelvic cancer pain, analgesic consumption and adverse opioids-related side effects. Interventional pain management should be considered at earlier stages to provide patients with the best quality of life possible.
Autonomic Nerve Block ; Humans ; Nerve Block ; Pain Management ; Pelvic Neoplasms ; Quality of Life

OBJECTIVE: Image-guided surgical system has been widely used in neurosurgical field for minimally invasive surgery. We evaluate the efficacy of a new neuronavigation system developed by ourselves to neurosurgical procedures. METHODS: Application accuracy was estimated for evaluation of interactive localization of intracranial lesions. A phantom was mounted with ten frameless markers which were randomly distributed on its surface. Target points were digitized and the coordinates were recorded and compared with reference points. Root mean square (RMS) errors of the coordinates were calculated. The system was used in six cases with MR imaging. We evaluated for its utility, ease of integration, reliability, and intraoperative accuracy. RESULTS: Application accuracy is a crucial factor for stereotactic surgical localization system. The estimated RMS error was 1.2+/-0.5mm. This degree of accuracy was comparable to that of other reports. Clincally, it was helpful in preoperative planning, deciding the site and location of craniotomy and judging the anatomical position of intracerebral lesion. CONCLUSION: This system provides an accurate and reliable means for localizing lesions within the brain and identifying underlying anatomical structure. We could minimize surgical morbitidy and operation time.
Brain ; Craniotomy ; Magnetic Resonance Imaging ; Neuronavigation* ; Neurosurgical Procedures ; Surgery, Computer-Assisted ; Surgical Procedures, Minimally Invasive