Clinical neurology and neurosurgery
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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.
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Clin Neurol Neurosurg · Feb 2009
Review Case ReportsManagement of subdural hematoma in immune thrombocytopenic purpura: report of seven patients and a literature review.
Intracranial hemorrhage is a devastating complication of immune thrombocytopenic purpura (ITP). Subdural hematoma (SDH) is rare and the optimal management unsettled. We report a series of seven patients of ITP who developed isolated SDH and subsequently review the literature. ⋯ Reports of isolated SDH in ITP are infrequent. Compared to those developing intracerebral hemorrhage, SDH occurs more in patients who are older, having chronic ITP and having a higher platelet count. Medical management with close monitoring of neurological parameters is a viable treatment option in patients of ITP developing SDH.