World Neurosurg
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Recommended treatments for spontaneous intracranial hypotension (SIH) range from bed rest only to neurosurgery. However, the serious form of SIH is poorly defined. A better description of patient characteristics and their outcome may help define therapeutic options. ⋯ The presence of SDHs, disturbance of consciousness, and a trend toward a longer time to diagnosis and recovery seem to define the serious form of SIH. These patients may require exploration and surgical repair of cerebrospinal fluid leak, only after failure of conservative measures--bed rest and time--and EBP, with good outcome.
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Case Reports
An alternative display could lead to earlier diagnosis of intracerebral pathology with a Hemedex flow probe in-situ.
To report 2 cases of patients who had an ischemic stroke and an intracerebral hematoma after a superficial temporal artery-middle cerebral artery bypass with a thermal diffusion blood flow probe in situ and emphasize how a change in the way the data are presented could have led to an earlier diagnosis. ⋯ Although there was good clinical correlation, data displayed on the perfusion monitor can be incorrectly interpreted because the signal-to-noise ratio is small. We therefore suggest an alternative presentation of perfusion data for clinicians to recognize hypoperfusion and to take informed action before a stroke or hematoma is clinically manifest.
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Meta Analysis Comparative Study
Clinical and radiological outcome after treatment of unruptured paraophthalmic internal carotid artery aneurysms: A comparative and pooled analysis of single-center experiences.
Unruptured paraophthalmic aneurysms present unique challenges, and the ideal management remains unknown. ⋯ Endovascular therapies have benefits over surgical clipping in terms of fewer intracranial hemorrhage complications, fewer NCs, and lower unfavorable visual outcome rate. Flow diversion showed comparative safety and effectiveness to stent-assisted coiling, and they both achieved better radiologic results than coiling alone. Further validation by randomized cohort studies is still needed to provide robust evidence.
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Multicenter Study
Clinical, Pathological, and Surgical Outcomes for Adult Pineoblastomas.
Pineoblastomas are uncommon primitive neuroectodermal tumors that occur mostly in children; they are exceedingly rare in adults. Few published reports have compared the various aspects of these tumors between adults and children. ⋯ Although this series is small, the data suggest that pineoblastomas in adults have a less aggressive clinical course than in children.