Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · May 2019
Meta AnalysisMeta-analysis of recent literature on utility of follow-up imaging in isolated perimesencephalic hemorrhage.
Isolated perimesencephalic subarachnoid hemorrhage is an uncommon, distinct subtype of subarachnoid hemorrhage with a more benign prognosis. A negative computed tomographic angiogram has been shown to be reliable in excluding aneurysmal rupture as the underlying etiology. However, some studies continue advocating for more imaging to determine a vascular cause in perimesencephalic subarachnoid hemorrhage. The objective of this study is to evaluate the evidence for use and utility of repeat angiographic imaging after a negative computed tomographic angiogram in patients with perimesencephalic subarachnoid hemorrhage. ⋯ Use of repeat angiographic imaging after a negative computed tomographic angiogram for perimesencephalic subarachnoid hemorrhage patients remains not uncommon, despite previous meta-analysis. Review of the more recent literature is consistent with previously published meta-analysis and shows limited benefits despite frequent use. In patients with a strictly defined perimesencephalic subarachnoid hemorrhage pattern and clinical picture consistent with perimesencephalic subarachnoid hemorrhage, an initial negative computed tomographic angiogram should be adequate and repeated follow-up studies can be avoided.
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Clin Neurol Neurosurg · May 2019
Risk factors for preoperative and late postoperative seizures in primary supratentorial meningiomas.
We performed a retrospective study to identify factors associated with preoperative and late postoperative seizures in primary supratentorial meningiomas. ⋯ Identifying factors associated with preoperative or late postoperative seizures may help guide treatment strategies, eventually improving the quality of life for patients with meningiomas.