J Neurosurg Sci
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Prognostic factors which affect treatment results of glioblastoma multiforme (GBM; WHO Grade IV) patients has been investigated in many researches. For these patients determination of prognostic factors helps generating multimodal therapy protocols. For this purpose, in the Baskent University Medical School, Neurosurgery Clinic, Adana Medical Research Center, specific characteristics of GBM patients who have surgery retrospectively investigated and factors which affect prognosis has been determined. ⋯ When independent prognostic factors were examined ,median survival found out 7.8 months longer fort he patients whose postoperative KPS were >or=70, 5.7 months longer for the patients who had radical resection, 6.6 months longer for the patients who had multiple operations. Although patients who had ConcT with adjuvant TMZ had 1.7 months longer survival compared to patients who had only adjuvant RT, it was not determined as an independent prognostic factor.
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An acute subdural hematoma is commonly regarded as a complication of a head injury, and bleeding is associated with contusion or laceration of the bridging vein in the subdural space. Occasionally, reports describe non traumatic acute subdural bleeding from the rupture of cerebral aneurysm or vascular malformation. However, acute spontaneous subdural hematomas (ASDH) of arterial origin, without any traumatic history or vascular anomaly, are rarely reported in literature. Here we describe two cases who presented with acute signs of intracranial hypertension secondary to a spontaneous acute subdural hematoma in which spontaneous bleeding from a small cortical artery was seen during operation.
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Review Case Reports
Parafalcine chondrosarcoma: report of a case and review of the literature.
Intracranial chondrosarcomas are cartilaginous tumours that are extremely rare with an estimated incidence of less than 0.16% of all intracranial neoplasms. They arise from the skull base synchondrosis or exceptionally from cartilaginous rests within the dura mater. ⋯ Intracranial chondrosarcomas are more frequently seen between 3 months and 76 years of age, with a peak around the third decade, with an equal sex distribution. The authors report a case of a 32-year-old woman with a chondrosarcoma of the falx cerebri.
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Most patients undergoing neurosurgery are considered at increased risk for venous thromboembolism (VTE). Several studies have demonstrate that intracranial surgery, malignancy, leg weakness, prolonged procedures and advanced age can to increase VTE. ⋯ This article wants to show the practical use of IPC in neurosurgery, following the guidelines developed by American College of Chest Physicians (ACCP) and used by the most important medical societies such as American Association of Neurological Surgeons (AANS) and European Association of Neurosurgical Societies (EANS). Several studies have demonstrated that IPC use is effective as LMWH, safe and economic.
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Case Reports
Paraparesis following straining accompanied by spontaneous thoracolumbar spinal epidural hematoma: a case report.
Spontaneous spinal epidural hematoma (SSEH) is a rare disease that requires emergency surgical intervention because it can cause serious and permanent neurological damage. Its etiology is related to coagulopathy, vascular malformation, hypertension, neoplasms, infections and idiopathic causes. It is frequently observed in the cervicothoracic and thoracolumbar regions. ⋯ Therefore, prompt and effective surgical intervention is critical in patients with a thoracolumbar SSEH. We conclude that prognosis would be better than it is if patients with complete neurological damage were to undergo spinal decompression within the first 36 hours, and patients with incomplete neurological damage were operated on in the first 48 hours. We report a 71-year-old female patient with a history of aspirin use who developed paraparesis accompanied by SSEH following straining, and emphasize the importance of early surgical treatment.