Acta neurochirurgica
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Acta neurochirurgica · Sep 2009
Management of brachial plexus region tumours and tumour-like conditions: relevant diagnostic and surgical features in a consecutive series of eighteen patients.
Tumours of the brachial plexus region are rare and most publications are case reports or studies with a small series of patients. The aim of this study is to present our experience in managing these lesions. ⋯ The majority of tumours were benign and most of them could be excised with a low incidence of additional deficits. Some of the malignant tumours could be controlled by surgery plus adjuvant therapy, but this category is still associated with high morbidity and mortality rates.
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It has been recently shown that A6 cells exposed to hyponatraemic stress respond with increased sodium uptake via activation of benzamil-sensitive sodium channels. This study was performed, therefore, to explore the possible involvement of benzamil-sensitive sodium channels and cellular sodium influx in brain oedema formation in hyponatraemic rats. ⋯ Early in the course of hyponatraemia, brain sodium channels may be activated, and the subsequent cellular sodium uptake may generate osmotic gradient to allow passive water flow into the cells. The simultaneous reduction of osmotic water conductivity of brain-specific aquaporin-4 by hyponatraemia, however, may limit water accumulation.
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Acta neurochirurgica · Sep 2009
Case ReportsSymptomatic enlargement of an occluded giant carotido-ophthalmic aneurysm after endovascular treatment: the vasa vasorum theory.
We describe a patient with a symptomatic left giant carotido-ophthalmic aneurysm who initially underwent coil embolization with subtotal obliteration. The patient's symptoms were initially stable, but 1 year later, she presented with a rapidly progressive contralateral visual deficit. Although angiogram showed a stable neck remnant, MR confirmed aneurysm growth and showed a new peripheral hematoma in the wall of the thrombosed aneurysm. ⋯ The patient's recent visual deficit markedly improved, and the angiogram did not reveal any residue. Giant aneurysms may continue to grow due to a hypertrophic vasa vasorum and subadventitial hemorrhages. Surgery should be considered if complete thrombosis of the aneurysm does not alleviate patient's symptoms.
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Acta neurochirurgica · Sep 2009
Case ReportsRuptured subclavian artery pseudo-aneurysm associated with Neurofibromatosis type 1.
A subclavian artery aneurysm associated with Neurofibromatosis type 1 (NF 1) is extremely rare. We report a ruptured pseudo-aneurysm of the subclavian artery in a patient with NF 1 treated with endovascular surgery. ⋯ Our patient is the first reported example of successful endovascular treatment for a ruptured subclavian artery pseudo-aneurysm associated with NF 1. Endovascular stenting and coil embolisation for the ruptured subclavian artery pseudo-aneurysm was very effective.
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Acta neurochirurgica · Sep 2009
How often does an incomplete circle of Willis predispose to cerebral ischemia during closure of carotid artery? Postmortem and clinical imaging studies.
To evaluate the prevalence of anatomical variations in the circle of Willis predisposing to cerebral ischemia during intraoperative closure of a carotid artery. ⋯ Incomplete circle of Willis predisposes approximately one-sixth of individuals to cerebral ischemia during transient closure of carotid artery but the risk is more than threefold in case of contralateral ICA occlusion.