Surg Neurol
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Cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) remains a major complication in patients suffering from SAH. In our previous study, we reported that stimulating vascular K(+) channel activity prevented the development of cerebral vasospasm. Recent evidence indicates that glyceryl nonivamide (GLNVA), a capsaicin derivative, has a vasorelaxant effect on the aortic vascular smooth muscle due to the release of coronary calcitonin gene-related peptide, which in turn stimulates K(+) channel opening. The purpose of the present study was to examine the preventive effects of GLNVA on vasospasm. ⋯ The findings showed that GLNVA dose-dependently attenuated cerebral vasospasm after SAH in the rabbit. These results suggest that intrathecal administration of GLNVA could be an effective strategy for preventing cerebral vasospasm after SAH.
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Osteomas of the paranasal sinuses rarely lead to intracranial manifestations. We present an unusual case of a frontal sinus osteoma leading to intracerebral abscess formation. ⋯ The frontal sinus osteoma was associated with rapid development of a frontal lobe abscess, requiring emergent surgical debridement. Although rare, intracerebral manifestations should be considered and expected as a cause of new neurological deficits in the presence of paranasal sinus osteoma.
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Review Case Reports
Parafalcine chondrosarcoma: an unusual localization for a classical variant. Case report and review of the literature.
Intracranial chondroid tumors are infrequently seen in neurosurgical practice. These tumors usually arise from cartilaginous synchondroses at the base of the skull, but occasionally from the pluripotential mesenchymal cells of the meninges. We present here a case of classic low-grade giant chondrosarcoma of the falx cerebri. This is only the second case of this variant reported in this location, and we summarize the diagnostic criteria with a brief review of literature. ⋯ Intracranial cartilaginous tumors include classical, mesenchymal and myxoid chondrosarcomas in addition to benign chondromas. Parafalcine localization should be considered for all these variants as well as for meningiomas, hemangiopericytomas, solitary fibrous tumors, and meningeal metastatic carcinomas. Detailed radiological evaluation, light microscopic and ultrastructural analyses, and immunocytochemistry are essential for correct diagnosis. In contrast to mesenchymal and myxoid types, the prognosis of classic variants is usually good and does not require adjuvant treatment modalities if a radical resection of the tumor can be obtained. Increased documentation of clinical, radiological, and histologic findings as well as response to treatment modalities will provide a better understanding of the pathophysiology of these rare tumors, and highlight the optimum treatment strategies
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Only during the past 10 years have spontaneous cerebellar hemorrhages became a well-defined nosological entity. The surgical indication remains debatable. Our primary objective in this study was to set the criteria for undertaking surgery by determining the critical diameter of the hematoma and considering the patients' neurological status (Glasgow Coma Scale). ⋯ In patients presenting with spontaneous cerebellar hemorrhage the essential criteria indicating surgery are a hematoma 40 mm x 30 mm on CT imaging in the cerebellar hemisphere or 35 mm x 25 mm on CT imaging in the vermis, the presence of a tight posterior fossa (critical size reduced by 10 mm), and a Glasgow Coma Score less than 13.
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While rupture of a cerebral aneurysm into the subdural space is rare, aneurysmal subarachnoid hemorrhage in the presence of subdural hematoma(s) is much more uncommon. Such a patient requires changes in routine perioperative management. ⋯ Changes in standard techniques for a patient undergoing a pterional craniotomy for a ruptured cerebral aneurysm are required when bilateral extra-axial mass lesions are present.