World Neurosurg
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Traumatic brain injury (TBI) stands out as a grave social and economic problem. Emerging countries possess few epidemiologic studies on the range and impact of TBI. ⋯ TBI should be recognized as an important public health problem in Brazil because it is responsible for considerable social and economic costs. Besides the young adult age group (20-29 years old), the geriatric age group is especially vulnerable to the frequent and devastating consequences of TBI. The implementation of a system of effective epidemiologic vigilance for neurotrauma is urgent in Brazil and other countries worldwide.
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Language dysfunction, visual deficit, numeracy impairment, and Gerstmann syndrome often occur in the cortical area; furthermore, the subcortical white matter is the inviolable limit of "functional neurosurgery." Preoperative functional magnetic resonance imaging (fMRI) and tractography are capable of providing the data required for safe "surgical planning" at both the cortical and subcortical levels. ⋯ Our results suggest that this approach is completely safe and effective as an alternative to awake surgery.
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Neuroendoscopy is increasingly being used in the management of intraventricular brain tumors. The role of endoscopy in diagnostic biopsy is well established. Expansion of these techniques may allow for definitive resection of intraventricular tumors. We report the feasibility and outcomes of endoscopic resection of select intraventricular tumors in children. ⋯ Neuroendoscopic gross-total resection of solid intraventricular tumors is a safe and efficacious procedure in carefully selected pediatric patients.
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We present a new case of angioleiomyoma, with detailed preoperative magnetic resonance imaging and digital subtraction angiography studies. A 36-year-old man was referred to our hospital for headache and diplopia. ⋯ The residual tumor was treated with CyberKnife, which, to our knowledge, is the first use of CyberKnife treatment for intracranial angioleiomyoma. At 20 months postoperatively, the size of the residual tumor had been reduced.
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Case Reports
Adult Intramedullary Teratoma of the Spinal Cord: A Case Report and Review of Literature.
Teratomas of the spinal cord constitute 0.1% of all spinal tumors, and these lesions are extremely rare in adults. The authors describe a rare case of intradural intramedullary teratoma of the conus medullaris and perform review of literature of intramedullary teratomas seen in the thoracolumbar region. ⋯ Teratomas should be taken into consideration in the differential diagnosis of intramedullary lesions when the imaging reveals variable signal intensity because of tissue heterogeneity. A partial resection is a viable treatment option when the lesion is attached to vital structures because of the low recurrence rates reported in the literature.