World Neurosurg
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To conduct a survey of the AOSpine community to determine international perceptions of key predictors of outcome in patients with cervical spondylotic myelopathy. This knowledge will guide the development of clinical prediction models and allow the alignment of clinical perceptions with evidence-based reality. ⋯ This survey summarizes surgeons' perceptions of the most important predictors of outcome and provides insight into how surgeons undertake decision making.
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Chronic renal failure (CRF) is associated with a high incidence of stroke. In particular, the mortality rate for intracerebral hemorrhage (ICH) patients with hemodialysis (HD) due to advanced stage CRF is high, and the annual number of such cases is increasing. Therefore, we retrospectively investigated 5 years of clinical data from patients with ICH in our institution to reveal differences in the clinical courses of HD and non-HD patients and to identify risk factors for poor outcomes in ICH patients with HD. ⋯ Mortality in ICH patients with HD was associated with lack of antihypertensive drug use. Therefore, strict control of blood pressure is needed in HD patients to prevent ICH, especially on intermittent HD days or before the HD procedure.
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Infection associated with an intracranial meningioma is an extremely rare condition. Only six cases have been described in the literature. Because of its dual pathologies, initial radiologic diagnosis can be difficult. We present the first reported case of multiple infected intracranial meningiomas and correlate the radiologic and histologic findings. ⋯ In the appropriate clinical context, diffusion-weighted imaging and apparent diffusion coefficient map aid the diagnosis of infected intracranial meningiomas.
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Case Reports
Laser-interstitial thermal therapy for refractory cerebral edema from post-radiosurgery metastasis.
Stereotactic radiosurgery is often an effective tool for the treatment of brain metastases. A complication of radiosurgical treatment for brain metastasis can be persistent cerebral edema. Treatments of this refractory cerebral edema include observation, corticosteroids, and surgical resection of the edema-inducing mass. Laser-interstitial thermal therapy is a minimally invasive technique for ablating intracranial lesions. It may provide a treatment option for metastases after radiosurgery causing refractory cerebral edema. ⋯ Laser-interstitial thermal therapy may be a treatment option for refractory cerebral edema after stereotactic radiosurgery to a metastasis. This therapy may be of particular use in deep-seated lesions refractory to corticosteroid therapy.