World Neurosurg
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Current prognostic models for traumatic brain injury (TBI) are developed from diverse historical data sets. We aimed to construct a prognostication tool for patients with severe TBI, as this group would benefit most from an accurate model. ⋯ Two accurate prognostic models, NNI Clinical and NNI+, were developed from our cohort of patients with severe TBI. Both models are specific to severe TBI and could be better alternatives to current available models. External validation is required to assess performance of models in a different setting.
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Review Case Reports
Giant Cell Ependymoma of the Lateral Ventricle: Case Report, Literature Review, and Analysis of Prognostic Factors and Genetic Profile.
Giant cell ependymoma (GCE) is a rare primary central nervous system neoplasm. We report a case of GCE arising in the lateral ventricle. ⋯ Although rare, GCE should be considered in the differential of young patients with atypical intraventricular lesions, particularly given that extent of resection is associated with increased survival and GCE is thought to be radiation resistant.
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Comparative Study
Comparation of two operative methods for treating laterocollis and torticollis subtypes of spasmodic torticollis. Follow up of 121 cases.
The aim of this study was to compare the effects and complications of microvascular decompression (MVD) and neurectomy of spinal accessory nerve in the treatment of laterocollis and torticollis subtypes spasmodic torticollis (ST). ⋯ MVD for ST of laterocollis and torticollis subtypes can provide satisfactory and lasting improvements without nerve impairment. MVD is to be preferred to neurectomy of accessory nerve in treating ST of laterocollis and torticollis subtypes.
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Hyponatremia (defined as serum sodium <135 mEq/L) is the most common electrolyte abnormality in traumatic brain injury (TBI) and is also an independent predictor of poor neurologic outcome. The reported incidence of hyponatremia varies widely in literature reports, and there is continuing difficulty in clearly differentiating between the 2 common causes of hyponatremia with natriuresis: the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and cerebral salt wasting (CSW). We encounter hyponatremia frequently in our practice, and we therefore decided to review data from our center to estimate the incidence of hyponatremia and the results of our management strategies, and attempt to formulate simple guidelines for the correction of hyponatremia in TBI. ⋯ Early initiation of fludrocortisone in the setting of hyponatremia with natriuresis decreases the hospital stay. This protocol is probably safer in a tropical country where fluid restriction might be harmful. It also eliminates the need to differentiate between SIADH and CSW.
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Review Case Reports
Intradural-extramedullary capillary hemangioma with acute bleeding, case report and literature review.
Capillary hemangiomas are benign vascular tumors. They are commonly founded in the vertebral bodies but very seldom in the spinal cord. The most common symptom at onset is long-lasting axial pain without neurologic deficit. In rare cases, the onset may be acute with neurological deficit due to an intratumoral hemorrhage. ⋯ Intradural capillary hemangioma with acute intratumoral hemorrhage is a rare pathology, but it must be kept in mind because early diagnosis and treatment are key to achieve a good outcome. As far as we know, this is the first case reported of an intradural-extramedular capillary hemangioma that presents sudden neurologic deficit due to intratumoral bleeding.