Supplemental Digital Content is Available in the Text. Adding multicolumn spinal cord stimulation to optimal medical management improved pain relief, health-related quality of life, and function in a traditionally difficult to treat population of failed back surgery syndrome patients with predominant low back pain.

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ABSTRACT.Purpose: To evaluate the corneal sub-basal nerve plexus in patients presenting with hypoesthesia following surgery for trigeminal neuralgia. Methods: Twenty-one patients who had unilateral medically uncontrolled trigeminal neuralgia and underwent ipsilateral surgery from 2006 to 2012 were included. Of these, 10 had microvascular decompression (MVD group) and 11 had balloon compression of the trigeminal ganglion (BC group). Slit lamp examination, Cochet-Bonnet aesthesiometery and in vivo confocal microscopy were carried out on both eyes of each patient. Nerve density data were statistically analysed. Results: Corneal sensations and sub-basal nerve densities in MVD group were normal and equal in both the operated and unoperated sides, indicating that there was no intra-operative damage of the ophthalmic division of the trigeminal nerve (V1). However, those in BC group, despite having significantly reduced corneal sensations on the operated side (p = 0.007), did not demonstrate any significant difference in their sub-basal nerve densities (p = 0.477). No patient had any ocular symptoms. Conclusions: This study supports the hypothesis that complete ganglionic damage and/or postganglionic damage of V1 results in corneal hypoesthesia and neurotrophic keratitis, but partial ganglionic or preganglionic damage would preserve trophic function despite hypoesthesia and not result in clinically significant symptoms or signs of neurotrophic keratitis. The trophic and sensory functions of V1 are therefore independent and can be dissociated by disease or injury.

We suggest that the importance of SCH in modern epilepsy surgery is probably over-emphasised.

Despite its widespread use, the IMC trajectory performed poorly; PTS and CMC trajectories are more reliable ways of targeting the FILV when placing an EVD.

The standard of care for patients with newly diagnosed Glioblastoma multiforme (GBM) has remained unchanged since 2005, with patients undergoing maximal surgical resection, followed by radiotherapy plus concomitant and maintenance Temozolomide. More recently, Tumour treating fields (TTFields) therapy has become FDA approved for adult recurrent and adult newly-diagnosed GBM following the EF-11 and EF-14 trials, respectively. TTFields is a non-invasive anticancer treatment which utilizes medium frequency alternating electric fields to target actively dividing cancerous cells. TTFields selectively targets cells within mitosis through interacting with key mitotic proteins to cause mitotic arrest and cell death. TTFields therapy presents itself as a candidate for the combinational therapy route due to the lack of overlapping toxicities associated with electric fields. Here we review current literature pertaining to TTFields in combination with alkylating agents, radiation, anti-angiogenics, mitotic inhibitors, immunotherapies, and also with novel agents. This review highlights the observed synergistic and additive effects of combining TTFields with various other therapies, as well highlighting the strategies relating to combinations with electric fields.

Thesis AbstractIntroduction. This thesis explored patient experiences of awake craniotomy.Existing literature is scarce and dominated by quantitative methodologies. More recently two qualitative studies have provided a rich, but contrasting, understanding of the patients" experience of awake craniotomy.The methodological weaknesses of the existing literature are addressed, and the rationale for the study justified. Objectives.The aim of the study was to explore seven participants" experiences of awake craniotomy using interpretative phenomenological analysis.Methods. Single-site ethical approval was gained to conduct the study in one NHS Trust. All potential participants were approached who had undergone the awake craniotomy procedure at the NHS Trust. Semi-structured interviews were conducted with participants. Interviews were transcribed verbatim and analysed using an interpretative phenomenological analysis framework.Results. Analysis of transcripts yielded three superordinate themes: selfpreservation, operation environment and information. The superordinate themes were interpreted as interconnected with each other, as well as embedded in a core theme: relationship with the neurosurgeon. The three superordinate themes are presented and discussed within the journal article.The extended paper elaborates on two of these superordinate themes. References 93Appendices 107 Tables Table 1: Interview Schedule 6 Table 2: Participant Information 9 List of AbstractObject: Previous research exploring the patient experience of awake craniotomy has yielded inconsistent results. In the current study the authors aimed to explore the lived experience of having undergone an awake craniotomy in the United Kingdom.Methods: Seven participants took part in the study, which used a qualitative research methodology. Each participant was interviewed using a semi-structured interview schedule. Interviews were audio recorded and transcribed verbatim. Transcripts were analysed using interpretative phenomenological analysis.Results: Three superordinate themes: self-preservation, operation environment and information were identified. It was interpreted that each of these themes was embedded in a core theme: relationship with the neurosurgeon. Conclusions:The relationship with the neurosurgeon appears crucial to the patient experience of awake craniotomy: from brain tumour diagnosis to discharge. This knowledge requires consideration in clinical settings and could lead to improved delivery of care in the future.

The study demonstrates that STN morphology can be depicted using SWI MRI and coincides reliably with the electrophysiological MER boundary. Thus, this imaging modality can be used to refine STN direct targeting protocols in DBS surgery for PD.