Pub Date : 2008-06-01DOI: 10.1227/01.NEU.0000333455.99024.6F
D. Placantonakis, M. Tomishima, Fabien G. Lafaille, Sabrina C. Desbordes, Fan Jia, N. Socci, A. Viale, Hyojin Lee, Neil L Harrison, L. Studer, V. Tabar
S OF OPEN PAPERS controls. Injection of Ad-GAD65 into the trigeminal ganglion also resulted in long-term analgesia following a chronic constriction injury of the infraorbital nerve, a model of orofacial neuropathic pain. Immunohistochemical analysis showed that adenovirus-mediated GAD65 was expressed mainly in the satellite glial cells that surround the perikarya of sensory neurons in the trigeminal ganglion, suggesting that the analgesic effects were mediated by an intraganglionic, paracrine release of GABA. CONCLUSION: Adenoviral vector-mediated expression of GAD65 is a suitable means to synthesize GABA in sensory ganglia and produce analgesia in different pain models. 884 Negative Exploration during Microvascular Decompression: Initial Experience with Intraoperative Glycerol Rhizotomy for Trigeminal Neuralgia Richard S. Zimmerman, M.D., Amy Theiler, PA-C, Naresh P. Patel, M.D. INTRODUCTION: Microvascular decompression (MVD) has been shown to be effective for trigeminal neuralgia (TN). Although patient selection criteria and outcome have been described in detail, there are few reports in the literature focusing on options when the exploration is negative for vascular compression of the trigeminal nerve. One option involves partial sectioning of the root with complications such as facial numbness and incomplete or no pain relief. We describe an alternative, namely open glycerol rhizotomy (OGR), carried out intraoperatively when no discreet vascular compression is observed. METHODS: A total of 101 consecutive MVD cases for TN were reviewed, 14 of which had no vascular compression identified by an experienced surgeon. Included in these 14 were patients who failed previous procedures (e.g., MVD, gamma knife). For the 14 negative explorations, a droplet of glycerol was placed 3 to 4 mm distal to the root entry zone of the sensory portion of the trigeminal root. These cases were retrospectively reviewed for follow-up and to evaluate outcomes. RESULTS: The procedure was tolerated well by all patients. Thirteen of the 14 experienced immediate complete facial pain relief; seven of the 14 experienced initial facial numbness described as mild, but all patients retained their ipsilateral corneal reflex. Reassessment at 6 weeks revealed that nine of 14 had no pain, two were improved, and three had the same pain as prior to surgery. Between 6 months and 2 years after surgery, two patients restarted medication and two had a percutaneous glycerol rhizotomy. There were no cases of anesthesia dolorosa. There were no other neurological deficits and no deaths. CONCLUSION: Intraoperative glycerol rhizotomy appears to be effective when no significant vascular compression is observed and is associated with outcomes comparable to other rhizotomy techniques. Additional follow-up is necessary to establish long-term results, but the initial results suggest the potential for an alternative method of rhizotomy. Transgenic method for combinatorial expression of fluorescent
S的开放文件控制。向三叉神经节注射Ad-GAD65也可导致眶下神经慢性收缩损伤后的长期镇痛，这是一种口面神经性疼痛模型。免疫组化分析显示，腺病毒介导的GAD65主要在三叉神经节感觉神经元核周周围的卫星胶质细胞中表达，提示其镇痛作用是通过节内、旁分泌释放GABA介导的。结论:腺病毒载体介导GAD65在感觉神经节合成GABA，对不同疼痛模型产生镇痛作用是一种合适的手段。术中甘油根切断术治疗三叉神经痛的初步经验Richard S. Zimmerman, M.D.， Amy Theiler, PA-C, Naresh P. Patel, M.D.简介:微血管减压(MVD)已被证明对三叉神经痛(TN)有效。虽然已经详细描述了患者的选择标准和结果，但很少有文献报道关注三叉神经血管压迫探查阴性时的选择。一种选择是对牙根进行部分切断术，这会导致面部麻木、疼痛不完全缓解或无法缓解等并发症。我们描述了一种替代方法，即开放式甘油根切开术(OGR)，当术中没有观察到血管压迫时进行。方法:回顾了101例连续的MVD病例，其中14例经经验丰富的外科医生鉴定无血管压迫。在这14名患者中，包括先前手术失败的患者(例如，MVD，伽玛刀)。对于14次阴性探查，在三叉神经根感觉部分根进入区远3 ~ 4mm处放置一滴甘油。对这些病例进行回顾性回顾，以便随访并评估结果。结果:所有患者对手术耐受良好。14名患者中有13名面部疼痛立即完全缓解;14例患者中有7例出现轻度面部麻木，但所有患者均保留同侧角膜反射。6周重新评估显示，14名患者中有9名没有疼痛，2名有所改善，3名疼痛与手术前相同。术后6个月至2年，2例患者重新开始用药，2例患者行经皮甘油根切断术。无麻醉后麻醉的病例。没有其他神经功能缺陷，也没有死亡。结论:术中甘油根切断术在没有观察到明显的血管压迫时是有效的，其结果与其他根切断术相当。进一步的随访是必要的，以确定长期的结果，但初步结果表明，潜在的替代方法的根切断术。荧光蛋白组合表达的转基因方法。小鼠齿状回海马颗粒神经元(蓝色)。来自，Livet J, Weissman TA, Kang H, Draft RW, Lu J, Bennis RA, Sanes JR, Lichtman JW:神经系统荧光蛋白组合表达的转基因策略。《自然》，2007。见Elder, 1358-1359页。
{"title":"Enriched motor neuron populations derived from bacterial artificial chromosome-transgenic human embryonic stem cells.","authors":"D. Placantonakis, M. Tomishima, Fabien G. Lafaille, Sabrina C. Desbordes, Fan Jia, N. Socci, A. Viale, Hyojin Lee, Neil L Harrison, L. Studer, V. Tabar","doi":"10.1227/01.NEU.0000333455.99024.6F","DOIUrl":"https://doi.org/10.1227/01.NEU.0000333455.99024.6F","url":null,"abstract":"S OF OPEN PAPERS controls. Injection of Ad-GAD65 into the trigeminal ganglion also resulted in long-term analgesia following a chronic constriction injury of the infraorbital nerve, a model of orofacial neuropathic pain. Immunohistochemical analysis showed that adenovirus-mediated GAD65 was expressed mainly in the satellite glial cells that surround the perikarya of sensory neurons in the trigeminal ganglion, suggesting that the analgesic effects were mediated by an intraganglionic, paracrine release of GABA. CONCLUSION: Adenoviral vector-mediated expression of GAD65 is a suitable means to synthesize GABA in sensory ganglia and produce analgesia in different pain models. 884 Negative Exploration during Microvascular Decompression: Initial Experience with Intraoperative Glycerol Rhizotomy for Trigeminal Neuralgia Richard S. Zimmerman, M.D., Amy Theiler, PA-C, Naresh P. Patel, M.D. INTRODUCTION: Microvascular decompression (MVD) has been shown to be effective for trigeminal neuralgia (TN). Although patient selection criteria and outcome have been described in detail, there are few reports in the literature focusing on options when the exploration is negative for vascular compression of the trigeminal nerve. One option involves partial sectioning of the root with complications such as facial numbness and incomplete or no pain relief. We describe an alternative, namely open glycerol rhizotomy (OGR), carried out intraoperatively when no discreet vascular compression is observed. METHODS: A total of 101 consecutive MVD cases for TN were reviewed, 14 of which had no vascular compression identified by an experienced surgeon. Included in these 14 were patients who failed previous procedures (e.g., MVD, gamma knife). For the 14 negative explorations, a droplet of glycerol was placed 3 to 4 mm distal to the root entry zone of the sensory portion of the trigeminal root. These cases were retrospectively reviewed for follow-up and to evaluate outcomes. RESULTS: The procedure was tolerated well by all patients. Thirteen of the 14 experienced immediate complete facial pain relief; seven of the 14 experienced initial facial numbness described as mild, but all patients retained their ipsilateral corneal reflex. Reassessment at 6 weeks revealed that nine of 14 had no pain, two were improved, and three had the same pain as prior to surgery. Between 6 months and 2 years after surgery, two patients restarted medication and two had a percutaneous glycerol rhizotomy. There were no cases of anesthesia dolorosa. There were no other neurological deficits and no deaths. CONCLUSION: Intraoperative glycerol rhizotomy appears to be effective when no significant vascular compression is observed and is associated with outcomes comparable to other rhizotomy techniques. Additional follow-up is necessary to establish long-term results, but the initial results suggest the potential for an alternative method of rhizotomy. Transgenic method for combinatorial expression of fluorescent ","PeriodicalId":10381,"journal":{"name":"Clinical neurosurgery","volume":"13 1","pages":"125-32"},"PeriodicalIF":0.0,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85244321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-06-01DOI: 10.1227/01.NEU.0000333487.18324.36
J. Heller, Darric E. Baty, Ming Zhang, Hongbo Li, M. Adler, D. Ganea, J. Gaughan, C. Loftus, J. Jallo, R. Tuma
Spinal cord injury (SCI) is a tremendous public health problem in the United States and worldwide. The Centers for Disease Control and Prevention and the University of Alabama National Spinal Cord Injury Statistical Center estimate the annual incidence of SCI in the United States is between 11,000 and 12,000 injured per year.14,31 There are approximately 250,000 people in the United States living with disability related to an SCI.14,31 The cost of SCI to society is considerable, with a monetary estimate of more than $9,700,000,000 per year.14 Considering that more than half of individuals affected by SCI are young males between the ages of 15 and 29 years, the cost to society from loss of productivity may even be greater. Internationally, the incidence of SCI is increasing at an alarming rate, as motorization and in many regions violence increases. Although there have been advances in the care and rehabilitation of patients with SCI, currently there are unfortunately very few, if any, medical treatments for acute SCI that effect functional outcome.3,17,22 The current mainstay in medical therapy for acute injury is high-dose methylprednisolone.3,10–12,22,25 Many experts, however, believe that the risk of adverse events associated with high-dose steroids may outweigh the potential benefits gained through its use.22,25 According to Hurlbert, the continued use of steroids in acute SCI is “primarily out of peer pressure and fear of litigation.”22 Just as in traumatic brain injury, a complex array of secondary insults is responsible for ongoing neuronal damage after SCI.3,28 Neuroprotection is defined by Anderberg et al.3 as measures to “counteract secondary injury mechanisms and/or limit the extent of damage caused by self-destructive cellular and tissue processes.” Neuroprotective medications may be able to interrupt this destructive progression and theoretically have the potential to yield improved functional recovery.3 The search for neuroprotective agents that demonstrate efficacy in SCI is of paramount importance given the increasing incidence and devastating nature of the disease. Recently there has been an explosion of interest in the use of cannabinoids in treatment of central nervous system (CNS) diseases.2,4,8,13,15,18,20,32,34,36–38 Croxford15 identified multiple sclerosis, Parkinson’s disease, neuroprotection, analgesia, emesis, and anorexia and obesity all as areas with potential for the clinical application of cannabinoids. Our group has been exploring the role of cannabinoid receptor modulation in murine models of several CNS disorders such as stroke, multiple sclerosis, traumatic brain injury, and SCI.30,37,38 The term cannabinoid refers to any natural or synthetic compounds that resemble in structure and/or function those found naturally in the plant Cannabis sativa. Two types of cannabinoid receptors in the mammalian endocannabinoid system have been identified to date. The CB1 and CB2 receptors both work through Gi protein–coupled me
{"title":"The combination of selective inhibition of the cannabinoid CB1 receptor and activation of the cannabinoid CB2 receptor yields improved attenuation of motor and autonomic deficits in a mouse model of spinal cord injury.","authors":"J. Heller, Darric E. Baty, Ming Zhang, Hongbo Li, M. Adler, D. Ganea, J. Gaughan, C. Loftus, J. Jallo, R. Tuma","doi":"10.1227/01.NEU.0000333487.18324.36","DOIUrl":"https://doi.org/10.1227/01.NEU.0000333487.18324.36","url":null,"abstract":"Spinal cord injury (SCI) is a tremendous public health problem in the United States and worldwide. The Centers for Disease Control and Prevention and the University of Alabama National Spinal Cord Injury Statistical Center estimate the annual incidence of SCI in the United States is between 11,000 and 12,000 injured per year.14,31 There are approximately 250,000 people in the United States living with disability related to an SCI.14,31 The cost of SCI to society is considerable, with a monetary estimate of more than $9,700,000,000 per year.14 Considering that more than half of individuals affected by SCI are young males between the ages of 15 and 29 years, the cost to society from loss of productivity may even be greater. Internationally, the incidence of SCI is increasing at an alarming rate, as motorization and in many regions violence increases. Although there have been advances in the care and rehabilitation of patients with SCI, currently there are unfortunately very few, if any, medical treatments for acute SCI that effect functional outcome.3,17,22 The current mainstay in medical therapy for acute injury is high-dose methylprednisolone.3,10–12,22,25 Many experts, however, believe that the risk of adverse events associated with high-dose steroids may outweigh the potential benefits gained through its use.22,25 According to Hurlbert, the continued use of steroids in acute SCI is “primarily out of peer pressure and fear of litigation.”22 Just as in traumatic brain injury, a complex array of secondary insults is responsible for ongoing neuronal damage after SCI.3,28 Neuroprotection is defined by Anderberg et al.3 as measures to “counteract secondary injury mechanisms and/or limit the extent of damage caused by self-destructive cellular and tissue processes.” Neuroprotective medications may be able to interrupt this destructive progression and theoretically have the potential to yield improved functional recovery.3 The search for neuroprotective agents that demonstrate efficacy in SCI is of paramount importance given the increasing incidence and devastating nature of the disease. Recently there has been an explosion of interest in the use of cannabinoids in treatment of central nervous system (CNS) diseases.2,4,8,13,15,18,20,32,34,36–38 Croxford15 identified multiple sclerosis, Parkinson’s disease, neuroprotection, analgesia, emesis, and anorexia and obesity all as areas with potential for the clinical application of cannabinoids. Our group has been exploring the role of cannabinoid receptor modulation in murine models of several CNS disorders such as stroke, multiple sclerosis, traumatic brain injury, and SCI.30,37,38 The term cannabinoid refers to any natural or synthetic compounds that resemble in structure and/or function those found naturally in the plant Cannabis sativa. Two types of cannabinoid receptors in the mammalian endocannabinoid system have been identified to date. The CB1 and CB2 receptors both work through Gi protein–coupled me","PeriodicalId":10381,"journal":{"name":"Clinical neurosurgery","volume":"41 1","pages":"84-92"},"PeriodicalIF":0.0,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82212047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-06-01DOI: 10.1227/01.NEU.0000333456.37142.12
D. Agrawal, P. Steinbok
Image-guided surgery or neuronavigation has become an important part of the neurosurgical armamentarium in most centers around the world, primarily because it helps to improve patient safety and consistency of surgical results.1–5,8 However, these advantages come at the cost of increased health care and patient expenses. The disposable products used in image-guided surgery are often very costly. In developing countries such as India, hospitals may find money for large capital purchases, but often fail to budget for the price of consumables over the lifetime of the product. The lack of availability of the consumables may lead to underuse of the equipment. At the All India Institute for Medical Sciences, the Medtronic StealthStation (Medtronic Sofamor Danek, Inc., Memphis, TN) is used for neuronavigation, and the disposable fiducials cost INR4200 (US$100) for every procedure in which the StealthStation is used. As the average cost of consumables in major cranial surgery at our center is INR15000 (US$350), using neuronavigation can increase these costs by 25% simply because of the cost of fiducials. We therefore attempted to find less expensive available indigenous alternatives to replace the proprietary fiducials used with the StealthStation in image-guided neurosurgery.
{"title":"Fiducials: Achilles' heel of image-guided neurosurgery: an attempt at indigenization and improvement.","authors":"D. Agrawal, P. Steinbok","doi":"10.1227/01.NEU.0000333456.37142.12","DOIUrl":"https://doi.org/10.1227/01.NEU.0000333456.37142.12","url":null,"abstract":"Image-guided surgery or neuronavigation has become an important part of the neurosurgical armamentarium in most centers around the world, primarily because it helps to improve patient safety and consistency of surgical results.1–5,8 However, these advantages come at the cost of increased health care and patient expenses. The disposable products used in image-guided surgery are often very costly. In developing countries such as India, hospitals may find money for large capital purchases, but often fail to budget for the price of consumables over the lifetime of the product. The lack of availability of the consumables may lead to underuse of the equipment. At the All India Institute for Medical Sciences, the Medtronic StealthStation (Medtronic Sofamor Danek, Inc., Memphis, TN) is used for neuronavigation, and the disposable fiducials cost INR4200 (US$100) for every procedure in which the StealthStation is used. As the average cost of consumables in major cranial surgery at our center is INR15000 (US$350), using neuronavigation can increase these costs by 25% simply because of the cost of fiducials. We therefore attempted to find less expensive available indigenous alternatives to replace the proprietary fiducials used with the StealthStation in image-guided neurosurgery.","PeriodicalId":10381,"journal":{"name":"Clinical neurosurgery","volume":"32 1","pages":"80-3"},"PeriodicalIF":0.0,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86768279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-06-01DOI: 10.1227/01.NEU.0000333524.54656.42
A. Heimberger, L. Kong, Mohamed K. Abou-Ghazal, Chantal Reina-Ortiz, David S. Yang, Jun Wei, W. Qiao, R. Schmittling, G. Archer, J. Sampson, N. Hiraoka, W. Priebe, G. Fuller, R. Sawaya
Several recent clinical trials for high-grade gliomas have demonstrated promising results. Nonetheless, despite improvement in survival, these patients ultimately die of tumor progression. Malignant glioma patients are profoundly immunosuppressed, and a fundamental understanding of which types of glioma have immune resistance mediated by Tregs is required for developing and initiating specific immunotherapeutic approaches that may target these cells.
{"title":"The role of tregs in human glioma patients and their inhibition with a novel STAT-3 inhibitor.","authors":"A. Heimberger, L. Kong, Mohamed K. Abou-Ghazal, Chantal Reina-Ortiz, David S. Yang, Jun Wei, W. Qiao, R. Schmittling, G. Archer, J. Sampson, N. Hiraoka, W. Priebe, G. Fuller, R. Sawaya","doi":"10.1227/01.NEU.0000333524.54656.42","DOIUrl":"https://doi.org/10.1227/01.NEU.0000333524.54656.42","url":null,"abstract":"Several recent clinical trials for high-grade gliomas have demonstrated promising results. Nonetheless, despite improvement in survival, these patients ultimately die of tumor progression. Malignant glioma patients are profoundly immunosuppressed, and a fundamental understanding of which types of glioma have immune resistance mediated by Tregs is required for developing and initiating specific immunotherapeutic approaches that may target these cells.","PeriodicalId":10381,"journal":{"name":"Clinical neurosurgery","volume":"10 1","pages":"98-106"},"PeriodicalIF":0.0,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74207093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mapping the horizon: techniques to optimize tumor resection before and during surgery.","authors":"Nader Sanai, Mitchel S Berger","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10381,"journal":{"name":"Clinical neurosurgery","volume":"55 ","pages":"14-9"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28012624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"SPORT: what neurosurgeons need to know.","authors":"Peter D Angevine, Paul C McCormick","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10381,"journal":{"name":"Clinical neurosurgery","volume":"55 ","pages":"72-5"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28012630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lessons of the first era of psychosurgery.","authors":"Jack El-Hai","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10381,"journal":{"name":"Clinical neurosurgery","volume":"55 ","pages":"138-9"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28012639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ricardo J Komotar, Charles B Mikell, Guy M McKhann
{"title":"\"Epilepsy surgery\" versus lesionectomy in patients with seizures secondary to cavernous malformations.","authors":"Ricardo J Komotar, Charles B Mikell, Guy M McKhann","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10381,"journal":{"name":"Clinical neurosurgery","volume":"55 ","pages":"101-7"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28012634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tort reform: alternative models.","authors":"Alan M Scarrow","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10381,"journal":{"name":"Clinical neurosurgery","volume":"55 ","pages":"121-5"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28012636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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