Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Apr 2009
Consideration of epilepsy surgery in adults should be independent of age.
Epilepsy surgery is performed less frequently in persons over 45 years of age than in younger individuals, probably reflecting biases among patients, referring physicians and neurologists. ⋯ We report a favorable outcome from epilepsy surgery in a large series of older adults and conclude that age per se is not a contraindication to epilepsy surgery. We emphasize the lack of correlation between outcome from surgery and pre-operative duration of epilepsy.
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Clin Neurol Neurosurg · Apr 2009
Trigeminal schwannomas: a report of 42 cases and review of the relevant surgical approaches.
This study aims to achieve the complete removal of trigeminal schwannoma (TS) while preserving cranial nerve function. We focused on the outcomes of different surgical approaches and address the contributions of different operative techniques. Forty-two TS cases, treated surgically in Qilu Hospital during a 12-year period, were reviewed and analyzed. ⋯ In comparison to the conventional approach, the skull base approach provides better exposure of the tumors and increases the frequency of total and near-total/partial resections. Cavernous sinus involvement was the major impediment to total removal of the trigeminal schwannomas. Treatment always aims for total tumor resection; preservation or improvement of cranial nerve function can be achieved in most cases.
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Clin Neurol Neurosurg · Apr 2009
Clinical TrialEvaluation of brain biopsy in the diagnosis of severe neurologic disease of unknown etiology.
To determine the value of non-stereotactic brain biopsies in patients with severe neurologic disease of unknown etiology and indeterminate brain imaging. ⋯ Our data suggest that the value of non-stereotactic brain biopsy is sufficiently high and the morbidity sufficiently low to justify its use in carefully selected patients with severe neurologic disease that remains undiagnosed despite thorough less invasive evaluation.
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Clin Neurol Neurosurg · Apr 2009
Common carotid intima media thickness as a marker of clinical severity in patients with symptomatic extracranial carotid artery stenosis.
Increased common carotid artery intima-media thickness (CCA-IMT) is a risk factor for ischemic stroke and especially large vessel atherothrombotic infarction. However, the potential association of stroke severity with the intima-media thickening has not been previously studied. We sought to investigate the association between CCA-IMT and clinical severity of ischemic stroke in patients with symptomatic extracranial carotid artery stenosis (SCAS). ⋯ Increased CCA-IMT is independently associated with more severe stroke on admission in patients with SCAS.
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Clin Neurol Neurosurg · Apr 2009
Case ReportsEarly onset tension pneumocephalus following ventriculoperitoneal shunt insertion for normal pressure hydrocephalus: a case report.
The occurrence of tension pneumocephalus following ventriculoperitoneal (v.p.) shunt insertion is extremely rare, and is usually of delayed onset. We report a patient who developed an acute subdural tension pneumocephalus within 1 day following placement of a v.p. shunt for normal pressure hydrocephalus as a complication from shunt surgery.