Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Sep 2015
Rivaroxaban and intracranial haemorrhage after mild traumatic brain injury: A dangerous combination?
Despite several advantages of the novel anticoagulant rivaroxaban compared with vitamin K antagonists (VKA), its lack of specific antidotes to reverse anticoagulant effects may increase the risk profile of patients with bleeding complications. The purpose of this study was to analyze the effects of pre-injury treatment with rivaroxaban on patients with mild traumatic brain injury (TBI) and traumatic intracranial haemorrhage (tICH). ⋯ Despite major limitations of retrospective design and small patient numbers, our results suggest that rivaroxaban may exacerbate intracranial haemorrhage in patients with mild TBI. Further studies are needed to characterize the risk profile of this drug in patients with tICH.
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Clin Neurol Neurosurg · Sep 2015
Extradural transcavernous approach to cavernous sinus cavernous hemangiomas.
Cavernous sinus cavernous hemangioma (CSCH) is a rare extra-axial vascular lesion and is difficult to be removed due to their location, propensity for profuse bleeding during surgery, and relationship to complex neurovascular structures. The purpose of this study is to report our experience of the removal of CSCHs through a completely extradural transcavernous approach. ⋯ CSCHs are rare and challenging skull base tumors. The microsurgical resection, using an extradural transcavernous approach which allows complete tumor resection with an acceptable intraoperative and postoperative complications, should be considered as a favorable choice among all treatments.
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Clin Neurol Neurosurg · Sep 2015
Incomplete resection of lumbar synovial cysts – Evaluating the risk of recurrence.
Synovial cysts are generally located in the lumbar spine adjacent to facet joints. Most studies recommend surgical resection. Adhesions of the lumbar synovial cyst to the dura are common and can result in dural tears with subsequent CSF fistula or nerve injury. The recurrence rate after incomplete resection of lumbar synovial cysts is unclear. For this purpose, we report on our experience of 148 patients who underwent synovial cyst resection from 2000 to 2011. ⋯ Only in case of severe adhesions to the dura complete resection was not enforced to avoid dural tears. In none of the 8 patients symptomatic recurrence of synovial cysts occurred. Aware of the limited numbers, we suggest rather leaving remnants of an attached synovial cyst behind after a sufficient decompression than risking dural tears and surgery-related complications. This trial is registered with DRKS00006133.
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Clin Neurol Neurosurg · Sep 2015
ReviewEarly cranioplasty vs. late cranioplasty for the treatment of cranial defect: A systematic review.
Cranioplasty is considered as a routine procedure in everyday neurosurgical practice for the patient with cranial defect, however, there is no established consensus on optimal surgical timing. ⋯ Early CP can only reduce the duration of operation, but cannot reduce the complications of patients and even increase the risk of hydrocephalus. More evidence from advanced multi-center studies is needed to provide illumination for the timing selection of CP surgery.
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Clin Neurol Neurosurg · Sep 2015
Risk factors for predicting complications associated with growing rod surgery for early-onset scoliosis.
To identify risk factors for postoperative complications associated with growing rod surgery for early-onset scoliosis (EOS). ⋯ The occurrence of postoperative complications in growing rod surgery for EOS is most likely multifactorial and is related to curve magnitude in last follow-up and duration between growing-rod lengthening procedures.