World Neurosurg
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Observational Study
Relationship between successful extracranial-intracranial bypass surgeries and ischemic white matter hyperintensities.
Few studies have described regression of white matter hyperintensities (WMHs); however, no studies have described their recurrence or fluctuation. Thus, we aimed to study the course of WMHs on fluid-attenuated inversion recovery (FLAIR) magnetic resonance image (MRI) after extracranial-intracranial (EC-IC) bypass surgery and its correlation with the clinical outcome. ⋯ This study might be considered the first step to find a relationship between successful EC-IC bypass surgeries and the course of ischemic WMHs. It could also open the door for further studies to make more solid conclusions.
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To investigate effects of atorvastatin on conservative and surgical treatment of patients with chronic subdural hematoma. ⋯ Atorvastatin has preliminarily been proved to be safe and effective for chronic subdural hematomas in both conservative and surgical patients and can provide a drug treatment strategy for neurosurgeons.
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This retrospective study was designed to evaluate the effectiveness of autoclaving for the prevention of surgical site infection (SSI) after cranioplasty. ⋯ Autoclaving of autologous bone causes SSI after cranioplasty and it seems to increase the risk of non-MRSA infection by normal skin flora.
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Case Reports
Three cases of ruptured basilar artery dissections : from diagnosis to endovascular treatment.
Ruptured basilar artery dissections are rare, and prognosis is often disastrous. ⋯ These 3 cases illustrate different patient management strategies. We discuss this challenging condition and the current position of endovascular therapeutic techniques.
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Case Reports
Acute Foramen Magnum Syndrome following single diagnostic lumbar puncture: Consequence of a Small Posterior Fossa?
Type I Chiari malformation (CMI) is a rare complication of lumbar cerebrospinal fluid (CSF) drainage that is usually reported after lumbar drain or lumboperitoneal shunt placement. It usually remains asymptomatic; however, even if it becomes symptomatic, symptoms are usually mild. There are only a few reports of acute foramen magnum syndrome following continuous lumbar CSF drainage, and acute foramen magnum syndrome after a single diagnostic lumbar puncture (LP) has not been previously reported. We encountered this catastrophic complication in one of our patient. ⋯ The association of intracranial tumors and lumbar CSF drainage with CMI is uncommon. The documentation of a small posterior fossa signifies the importance of both developmental (small posterior fossa) and acquired (intracranial tumor/lumbar CSF drainage) factors in pathogenesis of CMI. Although the extreme rarity of acute deterioration following a single LP does not warrant LP to be contraindicated in such patients, documentation of resolution of CMI with postoperative MRI before performing lumbar CSF drainage (whether therapeutic or diagnostic), might be helpful in avoiding this rare complication.