RESUMO
BACKGROUND AND PURPOSE: Deep brain stimulation (DBS) for Parkinson disease (PD) has traditionally been reserved for the late stages of the disease. There is evidence that DBS is also effective if applied earlier in the disease course. Changes in the frequency of DBS procedures in the UK over a 15-year period were investigated. METHODS: A retrospective review was performed of patient age and disease duration for DBS surgery for PD in UK neurosurgical units from 1997 to 2012 using departmental databases. RESULTS: The number of DBS procedures in the UK increased from three in 1997 to over 80 per year during this period. The mean age at the time of surgery (60 years) and the mean duration of PD at the time of DBS (11 years) remained unchanged over 15 years. CONCLUSIONS: The age and disease duration at which DBS is performed for PD in the UK has been static over a 15-year period and DBS appears to remain a therapy for PD applied late in its course. This may change in the light of clinical evidence suggesting a benefit for earlier DBS.
Assuntos
Estimulação Encefálica Profunda/métodos , Doença de Parkinson/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estimulação Encefálica Profunda/estatística & dados numéricos , Estimulação Encefálica Profunda/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Reino UnidoAssuntos
Anticonvulsivantes/administração & dosagem , Astrocitoma , Neoplasias Encefálicas , Procedimentos Cirúrgicos de Citorredução/métodos , Lobo Frontal , Procedimentos Neurocirúrgicos/métodos , Convulsões , Idoso , Astrocitoma/diagnóstico por imagem , Astrocitoma/patologia , Astrocitoma/fisiopatologia , Astrocitoma/cirurgia , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/fisiopatologia , Neoplasias Encefálicas/cirurgia , Quimiorradioterapia Adjuvante/métodos , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Lobo Frontal/cirurgia , Humanos , Imageamento por Ressonância Magnética/métodos , Convulsões/diagnóstico , Convulsões/etiologia , Resultado do TratamentoRESUMO
Carotid-cavernous fistulas (CCF) are uncommon conditions, but cause significant morbidity if untreated. The majority of CCFs in young men are attributed to direct skull trauma. We present a case of CCF following a blunt injury to the neck.