Surg Neurol
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There are not many studies that address the selection of patients harboring malignant brain tumors for open surgery. It is necessary, especially in developing countries, to establish the standards because of their impact not only on the efficacy but also on the cost-effectiveness of surgery. With the concern to add information that may help in future studies about the decision making, we proposed to analyze factors associated with surgical complications and evaluate their influence on the functional status at 30 days after surgery. ⋯ We found that the neurologic and clinical preoperative condition and grade III gliomas were factors related to postoperative complications, whereas age, extent of resection, and number of surgeries were not risk factors. We believe that these conclusions provide an additional benchmark for future multicentric studies that focus on the selection criteria for resection of malignant brain tumors.
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Recent studies have suggested that EPO activates the CREB transcription pathway and increases BDNF expression and production, which contributes to EPO-mediated neuroprotection. We investigated whether EPO has a neuroprotective effect against ISCI in rats and examined the involvement of CREB protein phosphorylation in this process. ⋯ These results demonstrate that a single dose of EPO given before ISCI provides significant neuroprotection and potentiates the expression of pCREB in this region.
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Digital subtraction angiography has been used in the diagnosis of aneurysmal SAH and as a preoperative imaging method. However, new methods such as MRA and CTA are now deemed by many institutions to provide sufficient information to allow surgery to go ahead without a preliminary DSA scan. We report on 2 cases of SAH in which there were additional lesions that were difficult to evaluate because of the lack of DSA information. ⋯ As long as the CTA scan is of adequate quality and shows the aneurysm clearly, we consider that an additional DSA provides little useful information for surgery. However, in such cases, the information from a DSA scan is needed for the evaluation of secondary factors that are not directly associated with the aneurysm.
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Historical Article
The earliest document regarding the history of cranioplasty from the Ottoman era.
Cranioplasty is one of the significant neurosurgical procedures in which the technical advances and also, by some means, drawbacks are still continuing. According to archeological findings and anthropological studies, the earliest procedures regarding cranioplasty date back to just about the same period claimed for trepanation. Ancient surgeons from different geographical sites and cultures performed both practices with remarkable survival rates. ⋯ Further study of the Ottoman era documents revealed an intriguing text that was written about the repair of skull defects and that dates from early 16th century. This worthy discovery will add valuable contribution to the history of neurosurgery by drawing the written history of cranioplasty more than 60 years back and the use of organic grafts 160 years back. In the present study, this original text is discussed.
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Subdural fluid collections appear in about 39% of patients after the removal of intra- and paraventricular tumors. This extracerebral fluid collection requires surgical intervention when progressive fluid accumulation takes place. The authors retrospectively and prospectively studied the efficacy of gelfoam and fibrin adhesive in closing cortical and ependymal defects after intraventricular and/or paraventricular lesion resection to prevent the development of SFCs. ⋯ The use of gelfoam and fibrin adhesive to seal cortical and ependymal defects after a transcortical procedure might be a viable method of preventing the development of SFC.