Neurochirurgie
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Sarcoidosis is a systemic granulomatous disease of unknown etiology. The frequency of neurologic manifestations varies from 5 to 15% of cases. Systemic manifestations of sarcoidosis are often present and the diagnosis is still based on histopathological studies. ⋯ The prognosis is often good and 55% of patients reported have had a complete recovery. In case of failure, immunosuppressive and radiation therapy can be used. Surgery is indicated to establish tissue diagnosis, in the presence of increased intracranial pressure, or to remove brain tumor.
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Civilian Gunshot Wounds (GSWs) to the head are important causes of mortality. The severity of GSWs is related to several factors. Patients with GSWs tend to do very well or very poor depending on these factors. ⋯ The manuscript describes the clinical experience of penetrating missile injuries in a Turkish civilian practice. Mortality and/or poor outcome are relatively high in spite of the cases wounded by low-velocity weapons. We should emphasize that following stabilization of vital signs, all patients with GCS scores of 3 to 5 should be evaluated immediately with CT and treated conservatively. If it is appropriate the patients with a GCS score higher than 8 should undergo surgery. Patients with GCS scores of 6 to 8 should be followed closely and treated with surgery when necessary even if they have poor prognosis.