Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2014
Clinical features and surgical outcomes of sporadic cerebellar hemangioblastomas.
Sporadic hemangioblastomas show a strong preference for the cerebellum. We clarify the clinical characteristics and role of surgery in sporadic cerebellar hemangioblastomas. ⋯ Sporadic cerebellar hemangioblastomas are usually associated with cysts and are voluminous by the time of diagnosis. Because these tumors result in the mass effect of posterior fossa, surgical removal is preferable and safe, and can be a timely curative strategy to prevent neurological decline.
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Clin Neurol Neurosurg · Oct 2014
Review Meta AnalysisEffects of dexmedetomidine on outcomes following craniocerebral operation - a meta-analysis.
To evaluate the effect of dexmedetomidine on outcomes following craniocerebral operation and provide evidence for individualized medication. ⋯ Dexmedetomidine can reduce the hemodynamic response and play a role in brain protection.
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Clin Neurol Neurosurg · Oct 2014
Validation assessment of risk tools to predict outcome after thrombolytic therapy for acute ischemic stroke.
We evaluated the reliability of eight clinical prediction models for symptomatic intracerebral hemorrhage (sICH) and long-term functional outcome in stroke patients treated with thrombolytics according to clinical practice. ⋯ All eight clinical models for outcome prediction after thrombolysis for acute ischemic stroke showed fair predictive value in patients treated according daily practice. The s-TPI had the best discriminatory ability and was well calibrated in our study population.
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Clin Neurol Neurosurg · Oct 2014
Surgical outcomes after posterior fossa decompression with and without duraplasty in Chiari malformation-I.
Chiari malformation-I (CM) is one of the most controversial entities in the contemporary neurosurgical literature. Posterior fossa decompression (PFD) is the preferred treatment for CM with and without syringomyelia. A variety of surgical techniques for PFD have been advocated in the literature. The aim of this study was to evaluate our results of surgically treated patients for CM-I with and without syringomyelia; using extradural dura-splitting and intradural intraarachnoid techniques. ⋯ The present study reports favorable surgical outcomes with extra-dural decompression of the posterior fossa in patients CM-I without syringomyelia. For patients with syringomyelia and history of prior PFD, intradural intra-arachnoid decompression is required. The prior history of decompression was associated with unfavorable outcomes. The use of duraplasty was associated with longer duration of hospital stay and higher complication rate. Further large cohort prospective study is needed to provide any recommendation on the indication of intra or extradural decompression for a given CM-I patient.
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Clin Neurol Neurosurg · Oct 2014
Management and outcomes of malignant posterior reversible encephalopathy syndrome.
Recognition of severe forms of posterior reversible encephalopathy syndrome (PRES) has improved. Management of these patients remains challenging, particularly in patients with the combination of edema and hemorrhage. ⋯ In contrast to historical reports of high mortality rates (16-29%) for severe and hemorrhagic PRES variants, we had no fatalities and observed favorable functional outcomes with intracranial pressure monitoring and craniectomy for malignant PRES cases who fail medical ICP management.