J Neurosurg Sci
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Review Case Reports
Association of intracranial meningiomas and aneurysms. Report of three cases and review of the literature.
The Authors report three personal cases of association between meningioma and arterial aneurysm, both intracranial. Twenty-three similar cases are referred in the literature, bringing the total to 26. Of these 26, the overall average age at diagnosis was 48.3 years: 17 were females and 9 males. ⋯ Greater use of the latter would probably have revealed a higher incidence of this rare association. The greater frequency found of the association of aneurysm and multiple meningiomas makes it advisable to perform panangiography in all such cases. The best long-term results were obtained in the cases where the meningioma and aneurysm were operated simultaneously.
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The cardiovascular and respiratory complications and their treatment during the immediate postoperative period in the intensive care unit (ICU) are analyzed in 145 consecutive cases of supratentorial craniotomy. In this series, 87.5% of the patients remained in the unit less than 48 hours. In all, 67 cardiovascular disorders were observed in 49 subjects (33.7%). ⋯ Extubation was not performed in the operating room in 17.93% of the subjects, and seven patients in which it was had to be reintubated. The stay in the ICU was longer for those intubated (3.03 +/- 0.77 days). Mortality was 2.06%.
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The Authors report an analysis on 40 cases of craniocerebral gunshot wounds treated in a civil hospital over a 8-year period. The important role of CT for a correct diagnosis and treatment planning is stressed even though patients with a G. C. S. lower than 4 die regardless of their CT findings; subdural and intracerebral hematomas are not a serious complication unless patient's neurological status is poor; timing of surgical treatment plays a major role in order to avoid infection of the wound.
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In four cases with trigeminal neuralgia an intracranial neoplasm was detected. In the first two cases a meningioma of the cerebellopontine angle was producing symptomatic trigeminal neuralgia almost identical to the essential one. ⋯ In all four cases associated sensory trigeminal deficits were present. The causative factors which may produce symptomatic trigeminal neuralgia are especially discussed in this paper.
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A case of benign meningioma of the superior sagittal sinus is reported, which recurred three times during a period of six years. At the time of the first recurrence the overlying bone was eroded and the tumor grew subcutaneously; the second recurrence was associated with a pulmonary metastatic deposit of extraordinary size. The literature dealing with remote extracranial spread of meningiomas is briefly reviewed.