Albert Padgett (endera10)

The endoscope was used intermittently during the dissection to enhance the microscopic view especially for the anterolateral surface. At the end of the excision, the arachnoidal edges were apposed and welded together using a fine bipolar forceps at very low current setting under saline irrigation. The dura was closed water-tight. The wound was closed in layers. CONCLUSION The posterolateral approach combined with rotation of the spinal cord by dentate ligament stitch allows direct visualisation for lesions that present onto the anterolateral surface of the cord. OBJECTIVE Chronic abdominal pain (CAP) is a debilitating condition known for its multifactorial nature. However, outcomes with spinal cord stimulation (SCS) for abdominal pain syndromes are noticeably absent in the literature. To date, there have been no published reports of novel waveforms of SCS for the management of CAP. The aim of this study was to assess the efficacy and durability of BurstDRTM SCS in reducing abdominal pain and analgesic consumption. MATERIALS AND METHODS We performed a retrospective review of medical records from three patients with different etiologies of abdominal pain (post-herniorrhaphy pain syndrome, Crohn's disease, abdominal neuropathy). All patients underwent thoracic laminectomy for BurstDRTM SCS paddle lead and pulse generator placement and after a successful trial stimulation period. Data was collected with a telephone survey after a minimum duration of > 24 months following implantation. Pain scores were measured using a numeric rating scale (NRS). RESULTS Two out of three patients are entirely pain-free and report PGIC scores of 7 after a minimum duration of follow up of >24 months. While the third patient continues to have chronic and well as episodic abdominal pain, he was able to discontinue all narcotic pain medications and has experienced a 33% decrease in frequency and a 60% decrease in the severity of monthly pain exacerbations. He, too, reports satisfaction and a PGIC of 6. CONCLUSIONS BurstDRTM SCS is a new programming modality, and long-term follow up is necessary to determine its durability. Despite varying etiologies of abdominal pain, this series suggests BurstDRTM SCS might be effective as a treatment for abdominal pain syndromes, sustained for greater than two years. Future studies of SCS would benefit from standardized abdominal pain scores and high-powered studies using global patient registries. OBJECT Cerebral venous thrombosis (CVT) is a rare type of stroke whose pathophysiology differs from arterial stroke. CVT is treated with systemic anticoagulant therapy even in the setting of intracerebral hemorrhage. Patients who do not respond adequately may require decompressive surgery. The study objective was to examine the timing of anticoagulation in patients with CVT who require decompressive surgery through systematic literature review and consecutive case series. METHODS A Review of the literature was performed through PubMed using keyword search to identify case series and cohort studies examining timing of anticoagulation following decompressive surgery. Our case series included four patients who had decompressive surgery for hemorrhagic CVT between 1/1/2015 - 12/31/2016 at our comprehensive stroke center. RESULTS The literature review summarizes 243 patients from fifteen studies whose timing of anticoagulation varied. The review suggests anticoagulation can be safely resumed at 48 hours postoperatively based on larger series and as early as 12 hours in smaller series, especially when delivered as a half or prophylactic dose. In our case series, timing of anticoagulation varied slightly but was started or resumed within 38-44 hours postoperatively in three patients and was started at the time of decompressive surgery without interruption in one patient. No patient had worsening hemorrhage or new hemorrhage while two patients re-thrombosed. CONCLUSION Despite the lack of high-quality studies, this systemat