Neurosurgery
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Review Case Reports
Ectopic suprasellar growth hormone-secreting pituitary adenoma: case report.
Ectopic pituitary adenomas are rare. We present an unusual case of an ectopic growth hormone-secreting pituitary adenoma in the suprasellar space. ⋯ Although uncommon, growth hormone-secreting pituitary adenomas are encountered in the suprasellar region. They should be added to the differential diagnosis of tumors in this location.
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Review Case Reports
Contralateral hearing loss after vestibular schwannoma surgery: case report.
To describe a case of contralateral hearing loss (CHL) in vestibular schwannoma (VS) surgery and to discuss the factors potentially related with this complication. ⋯ A case of CHL after VS surgery is presented. The hearing loss proved to be endochlear in origin and irreversible in nature. Irreversible damage to the cochlea resulting from loss of cerebrospinal fluid or vascular injury is probably related in this case reported.
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Cerebral cavernous malformations (CCMs) affect more than one million Americans, predisposing them to a lifetime risk of hemorrhagic stroke and epilepsy. A potential role of the immune response in this disease has not been postulated previously but is compelling given the unique antigenic milieu of CCM lesions with sequestered thrombi and a leaky blood-brain barrier and the numerous examples of immune modulation of angiogenesis in other disease states. The objective of this article is to reveal novel observations about apparent immune responses in CCM lesions excised from human patients and to outline the potential pathobiological significance of these observations, specific hypotheses for future research, and potential clinical implications. ⋯ Immune response could play a role in or represent a potential marker of CCM lesion proliferation and hemorrhage or could otherwise contribute to lesion phenotype. The ongoing studies will generate preliminary data for future research aimed at comparing the immune response in quiescent versus clinically aggressive CCM lesions. An oligoclonal immune response shown in this research would stimulate future experiments to identify autoimmune or extrinsic antigenic triggers involved in CCM disease.
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Randomized Controlled Trial Comparative Study
The role of postoperative patient posture in the recurrence of traumatic chronic subdural hematoma after burr-hole surgery.
Chronic subdural hematoma (CSDH) is one of the most common types of intracranial hemorrhage, especially in the elderly, with a significant recurrence rate ranging from 9.2 to 26.5%. The role of postoperative patient posture in the recurrence of CSDH has not been studied sufficiently. ⋯ Assuming an upright posture soon after burr-hole surgery was associated with a significantly increased incidence of CSDH recurrence but not with a significant change in other position-related postsurgical complications. According to this result, it is not recommended that elderly patients assume an upright posture soon after burr-hole surgery to prevent postoperative atelectasis and dementia, as these might significantly increase the risk of CSDH recurrence.
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Comparative Study
Secondary insults in subarachnoid hemorrhage: occurrence and impact on outcome and clinical deterioration.
To study the occurrence of secondary insults during neurointensive care of patients with subarachnoid hemorrhage using a computerized multimodality monitoring system and to study the impact of secondary insults on clinical deterioration and functional outcome. ⋯ Elevated ICP not responding to treatment is predictive of clinical deterioration, whereas high CPP decreases the risk of clinical deterioration. It may be beneficial to not lower spontaneous high CPP in patients with subarachnoid hemorrhage.