Turk Neurosurg
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We describe a patient presented with sequential events of hemifacial spasm, cerebral infarction and fatal subarachnoid hemorrhage. All of them are seemingly separate entities. Radiological examination revealed that the cause was vertebrobasilar dolichoectasia (VBD) coexisting with a giant saccular aneurysm of basilar artery. ⋯ The condition is very rare and its progression may result in compression of brainstem and cranial nerves, ischemic and/or hemorrhagic stroke. The treatment of such condition is difficult and further research on the risk stratification of VBD for predicting stroke. Close monitoring and aggressive surgical interventions might be needed for high-risk patients.
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Lung cancer is the leading cause of cancer-related mortality worldwide. Pain is a common problem in these patients, yet inadequate or dissatisfactory management is prevalent. ⋯ CT-guided percutaneous cordotomy is an effective procedure that should be used in the treatment of cancer-related pain problems. We suggest that cordotomy should be preferred as soon as possible in patients who fail to respond to the classic analgesic therapy.
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To raise the awareness of the appropriate management of unusual clinical presentation of cervical disc herniation. ⋯ Brown-Sequard syndrome is a rare presentation of cervical disc herniation but accurate diagnosis, and early anterior spinal cord decompression lead to complete recovery of these cases.
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Case Reports
Clinical characteristics and outcomes of patients with cerebral herniation during continuous lumbar drainage.
The aim of this study was to investigate the clinical characteristics and outcomes of patients who developed cerebral herniation after continuous lumbar cerebrospinal fluid (CSF) drainage. ⋯ Cerebral herniation induced by continuous lumbar drainage is mostly reversible if early identification and prompt management are realized. Faster drainage speed may be associated with earlier occurrence of brain herniation during lumbar drainage.
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In demyelinating disease spectrum, tumor-like (tumefactive) demyelinating lesions (TDL) are rarely seen. Atypical imaging and clinical features of these lesions may cause misdiagnosis of tumor or abscess. ⋯ Although MRI, CSF and pathologic examination help in differential diagnosis of the mass lesions, close follow-up is still crucial for the definite diagnosis. A higher MS conversion rate was found in patients with a younger TDL onset age.