Journal of neurosurgery
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Journal of neurosurgery · May 2013
Case ReportsIntraarterial schwannoma in horizontal segment of middle cerebral artery causing subarachnoid hemorrhage.
A spontaneous subarachnoid hemorrhage (SAH) from the middle cerebral artery is most commonly caused by the rupture of saccular aneurysms and rarely by fusiform aneurysms or arterial dissections/dissecting aneurysms. To the authors' knowledge, this is the first report of an intraarterial neoplasm causing an SAH. ⋯ However, a pterional craniotomy revealed a well-circumscribed solitary tumor with a diameter of 15 mm involving the superior wall of the M1 segment as the cause of the SAH. Pathological examination demonstrated typical findings of a schwannoma, elongated cells with tapered, spindle-shaped nuclei and indistinct cell borders, and diffuse immunoreactivity for the S100 protein.
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Journal of neurosurgery · May 2013
Minimally invasive treatment of intracerebral hemorrhage with magnetic resonance-guided focused ultrasound.
Intracerebral hemorrhage (ICH) is a major cause of death and disability throughout the world. Surgical techniques are limited by their invasive nature and the associated disability caused during clot removal. Preliminary data have shown promise for the feasibility of transcranial MR-guided focused ultrasound (MRgFUS) sonothrombolysis in liquefying the clotted blood in ICH and thereby facilitating minimally invasive evacuation of the clot via a twist-drill craniostomy and aspiration tube. ⋯ The feasibility of transcranial MRgFUS sonothrombolysis was demonstrated in in vitro and cadaveric models of ICH. Initial in vivo safety data in a swine model of ICH suggest the process to be safe. Minimally invasive treatment of ICH with MRgFUS warrants evaluation in the setting of a clinical trial.
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Journal of neurosurgery · May 2013
High-frequency cortical activity associated with postischemic epileptiform discharges in an in vivo rat focal stroke model.
The postischemic brain has greater susceptibility to epileptogenic activity than physiologically healthy tissue. Epileptiform discharges are thought to exacerbate postischemic brain function. The aim of this study was to develop an in vivo focal stroke model in rats to characterize epileptiform activity. ⋯ These recordings provide the first intracortical evidence of a high-frequency component that could be an important element for diagnosis and intervention in postischemic epileptogenic activity. The early onset also suggests that HFOs could serve as a reliable method of detecting small epileptiform events and could be used as a consideration in deciding whether antiepileptic medications are appropriate as part of a patient's poststroke care.