Neurosurgery
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Meningiomas are the most frequently reported primary intracranial neoplasms, accounting for approximately 25% of all such lesions diagnosed in the United States. Few studies have examined the risk factors associated with a diagnosis of meningioma with two categories of exposure, hormones (both endogenous and exogenous) and radiation, most strongly associated with meningioma risk. Limited data are also available on long-term outcomes for meningioma patients, although it is clear that the disease is associated with significant morbidity and mortality. ⋯ This will increase the focus on this disease over the coming years as well as likely increase the reported prevalence of the disease. The increased emphasis on research dedicated to the study of brain tumors coupled with the advent of new tools in genetic and molecular epidemiology make the current era an ideal time to advance knowledge for intracranial meningioma. This review highlights current knowledge of meningioma epidemiology and new directions for research efforts in this field.
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Case Reports Multicenter Study
Balloon-in-stent technique for the constructive endovascular treatment of "ultra-wide necked" circumferential aneurysms.
Circumferential aneurysms, which incorporate >180 degrees of the circumference of the parent vessel, present a unique therapeutic challenge, particularly in circumstances in which a deconstructive treatment strategy is not feasible. We detail a novel technique for endovascular parent vessel reconstruction with aneurysm embolization. ⋯ The balloon-in-stent technique provides a practical and safe treatment strategy for the management of circumferential aneurysms that are not amenable to deconstructive embolization.
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In the late 8th century, the stage for Viking expansion was set by commercial expansion in northwest Europe, the pressure of an increasing population in limited territorial reserves, and the development of the Viking ships. The Norsemen traveled extensively over the oceans, south to the Holy Land, and north to the White Sea and settled over a wide area from Sicily to Greenland. Historical sources, including the reports by Adam of Bremen and the Icelandic Sagas, describe several expeditions from Greenland to Vinland (somewhere along the east coast of North America) in approximately AD 1000 and later. ⋯ They also excavated a smithy, outdoor cooking pits, boathouses, a bathhouse, and enclosures for cattle, in addition to several Viking artifacts. The finds were C dated to AD 990 +/- 30. The present report reviews historical and archaeological evidence indicating the sites to which the Vikings traveled and attempted to settle in the new world.
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Comparative Study
Polymerase chain reaction for the rapid detection of cerebrospinal fluid shunt or ventriculostomy infections.
Infection after cerebrospinal fluid (CSF) shunts or ventriculostomies is a common complication associated with significant morbidity and mortality. Polymerase chain reaction (PCR) is a powerful molecular technique that allows rapid and precise amplification of bacterial deoxyribonucleic acid (DNA) and has proven a powerful tool in the detection of a wide variety of clinically important infectious diseases. We analyzed specimens of CSF derived from ventriculoperitoneal shunts or external ventricular drains by using both conventional cultures and PCR and report herein our preliminary results. ⋯ These preliminary data suggest that PCR is a highly sensitive, rapid, and potentially promising modality for the detection and treatment of CSF shunt ventriculostomy infection.
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To report the clinical outcomes following treatment of trigeminal neuralgia with linear accelerator-based radiosurgery. ⋯ Linear accelerator-based radiosurgery for medication refractory trigeminal neuralgia provides effective pain relief with a low complication rate.