Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Feb 2016
WHO grade 1 meningioma recurrence: Are location and Simpson grade still relevant?
To examine whether Simpson grade and pathology location are still predictors of recurrence/progression free survival (RPFS) in WHO grade 1 cranial meningiomas. ⋯ Simpson grade remains a significant predictor of RPFS in WHO grade 1 meningioma surgery. However, tumour location was not significant in this series. We advocate different post-operative imaging surveillance protocols depending on gross total or sub total surgical resection.
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Clin Neurol Neurosurg · Feb 2016
The diagnostic performance of ultrasonographic optic nerve sheath diameter and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure.
To assess the diagnostic accuracy of ultrasonographic optic nerve sheath diameter (ONSD) measurement and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure (ICP). ⋯ While the ultrasonographic mean binocular ONSD (>4.53 mm) was completely accurate in detecting elevated ICP, color Doppler indices of the ophthalmic arteries were of limited value.
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Clin Neurol Neurosurg · Jan 2016
Review Meta Analysis Comparative StudyLaparotomy vs minimally invasive laparoscopic ventriculoperitoneal shunt placement for hydrocephalus: A systematic review and meta-analysis.
Ventriculoperitoneal shunt (VPS) surgery is the most commonly used method for the treatment of hydrocephalus. Traditionally, distal catheters in the VPS surgery have been placed either through a standard small open laparotomy or via a laparoscopic technique. Although there are many studies demonstrating the benefits of a minimally invasive approach, limited research has directly compared the two techniques used in VPS surgery. ⋯ There was no difference between the laparotomic and laparoscopic approaches in the length of hospital stay, complication rate, proximal shunt failure or infection rate. The present systematic review and meta-analysis demonstrated that the laparoscopic technique in VPS surgery is associated with reduced shunt failure and abdominal malposition compared to the open laparotomy technique, with no significant difference in rates of infection or other complications. The lack of studies with high levels of evidence may contribute to bias in our conclusions and the long-term relative merits require validation by further prospective, randomized studies.
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Clin Neurol Neurosurg · Jan 2016
Difference in white matter microstructure in differential diagnosis of normal pressure hydrocephalus and Alzheimer's disease.
Alzheimer's disease (AD) and normal pressure hydrocephalus (NPH) are both associated with cognitive decline and ventriculomegaly. While promising approach in differentiating between the two diseases, only a few diffusion tensor imaging (DTI) studies compared directly NPH and AD patients. The current study compares global whitematter (WM) alterations in AD and NPH addressing some of the methodological issues of previous studies. ⋯ Our analysis identified a pattern of WM diffusion alterations that can differentiate NPH patients from controls and AD patients.
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Clin Neurol Neurosurg · Jan 2016
Use of anti-platelet agents after traumatic intracranial hemorrhage.
To evaluate the risk of hemorrhagic complications associated with starting anti-platelet therapy (APT) after acute traumatic intracranial hemorrhage (tICH) and to examine the frequency of thrombotic complications. ⋯ The risk of immediate and delayed intracranial hemorrhages from initiating APT after tICH must be weighed against the morbidity of delaying indicated thrombotic prophylaxis. Our initial data indicates that hemorrhagic complications are infrequent, and thrombotic complications can have significant clinical consequences. Our retrospective review provides the first rates of complications for this patient population.