Neurosurgery
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Review Case Reports
Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for the Treatment of Hypothalamic Hamartomas: A Retrospective Review.
Hypothalamic hamartomas (HH) are rare lesions associated with treatment-resistant epilepsy. Open surgery results in modest seizure control (about 50%) but has a significant associated morbidity. Radiosurgery is limited to a subset of patients due to latent therapeutic effects. Magnetic resonance imaging-guided laser interstitial thermal therapy (LITT) offers a novel minimally invasive option. ⋯ LITT therapy for HH can achieve excellent rates of seizure control with low morbidity and a short postoperative stay in a majority of patients. Additional research is needed to assess the durability of results and the full spectrum of cognitive outcomes.
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Review Case Reports
Neoplastic Cerebral Aneurysm From Metastatic Nonsmall Cell Lung Carcinoma: Case Report and Literature Review.
Intracranial cerebral aneurysms secondary to neoplastic etiology are a very rare occurrence. There have only been 5 published reports of intracranial cerebral aneurysms secondary to metastatic lung cancer. Four of those five previously published reports have been secondary to nonsmall cell lung carcinoma, and only 1 case caused subarachnoid hemorrhage. To our knowledge, this is the first report of a lung cancer-associated superior cerebellar artery aneurysm. ⋯ Intracranial neoplastic cerebral aneurysms are extremely rare entities, and a rare cause of subarachnoid hemorrhage. This diagnosis should be considered in patients who present with concurrent metastatic cancer and cerebral aneurysm or aneurysmal subarachnoid hemorrhage. Early initiation of chemotherapy may be beneficial in reducing the risk of tumor-particle embolization, but more research needs to be conducted to better understand this rare phenomenon.
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The Barrow Neurological Institute (BNI) scale is a novel quantitative scale measuring maximal subarachnoid hemorrhage (SAH) thickness to predict delayed cerebral ischemia (DCI). This scale could replace the Fisher score, which was traditionally used for DCI prediction. ⋯ This multicenter external validation analysis confirms that patients with a higher BNI grade show a significantly higher risk for DCI; high BNI grade was a predictor for unfavorable outcome at discharge and 1FU.