Neurosurgery
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We report on a patient with a Chiari I malformation presenting with right hemifacial spasm. Clinicians should consider the downward displacement of the hindbrain as a rare cause of hemifacial spasm in Chiari I malformation. ⋯ The hemifacial spasm could be attributed to compression and/or traction of the facial nerve because of downward displacement of the hindbrain in Chiari I malformation. Compression and/or traction might create irritation of the facial nerve that causes hemifacial spasm. Resolution of the hemifacial spasm after posterior fossa decompression could explain the facial nerve irritation in Chiari I malformation. Clinicians should consider Chiari malformation as a cause of hemifacial spasm and posterior fossa decompression as a potential treatment.
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Review Case Reports
Primary extradural epithelioid leiomyosarcoma of the cervical spine: case report and literature review.
No case of primary epithelioid leiomyosarcoma involving the spine has been reported previously. ⋯ This is the first reported case of a primary craniospinal epithelioid leiomyosarcoma.
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Review Case Reports
Primary intracranial melanocytic tumor simulating pituitary macroadenoma: case report and review of the literature.
Primary intracranial melanocytic tumors are rare lesions, sellar ones being even more exceptional. So far, six melanomas and two melanocytomas have been described in an intrasellar and/or suprasellar location. ⋯ Primary sellar melanocytic neoplasms are extremely rare lesions and present with few differential diagnoses. Deciding whether the tumor is best classified as a melanocytoma or a melanoma may prove difficult. Wide histological variations in both melanocytomas and melanomas render careful consideration of the clinical, radiological, and gross features essential in distinguishing one from the other.
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Comparative Study
Impact of coil embolization on overall management and outcome of patients with aneurysmal subarachnoid hemorrhage.
We report on the consequences of introducing coil embolization for the total management of and outcome in patients with subarachnoid hemorrhage (SAH). ⋯ The increasing use of coil embolization for ruptured aneurysms in the anterior circulation did not have any significant impact on the overall incidence of SAH-related complications or outcome. The main determinant for outcome after SAH is still the severity of the SAH.
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Comparative Study
The simplified acute physiology score to predict outcome in patients with subarachnoid hemorrhage.
Current prognosticators for patients with subarachnoid hemorrhage (SAH) do not take into account signs of extracerebral organ dysfunction. This may explain the only moderate predictive value of these prognosticators. We assessed the prognostic value of the simplified acute physiology score (SAPS) II in SAH patients. ⋯ The SAPS II is a useful and reliable prognosticator in SAH patients. This score may provide more information than specific SAH scales in predicting poor outcome or the occurrence of delayed cerebral ischemia in some circumstances.