World Neurosurg
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A Rathke cleft cyst (RCC) with nonhemorrhagic rupture mimicking pituitary apoplexy has been reported rarely. ⋯ We conclude that nonhemorrhagic RCC rupture and subsequent leakage of the contents into subarachnoid space were the underlying pathogenesis in the present case of RCC resembling apoplexy.
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Case Reports
Transvenous embolization of the basilar plexus before endoscopic transsphenoidal transclival surgery: a case report.
The endoscopic transclival approach is a method for reaching the anterior side of the brainstem. In making this approach, bleeding from the basilar plexus is often observed when cutting the dura overlying the clivus. Controlling such bleeding is essential. ⋯ To our knowledge, this is the first report of transvenous embolization of the basilar plexus. If the basilar plexus is well developed on preoperative computed tomographic venography or digital subtraction angiography, this procedure is useful for controlling bleeding during endoscopic transclival surgery.
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In men with prolactinomas, impaired bone density is the principle consequence of hyperprolactinemia-induced hypogonadism. Although dopamine agonists (DAs) are the first-line approach in prolactinomas, surgery can be considered in selected cases. In this study, we aimed to investigate the long-term control of hyperprolactinemia, hypogonadism, and bone health comparing primary medical and surgical therapy in men who had not had prior DA treatment. ⋯ Despite control of hyperprolactinemia and hypogonadism in most patients independent of the primary treatment modality, the prevalence of impaired bone health status remains high, and osteodensitometry should be recommended.
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Although short-term clinical outcomes after basilar artery stent placement have been reported previously, effectiveness of intracranial stenting for vertebrobasilar artery occlusion in the acute phase of ischemic stroke is unclear. ⋯ Stent angioplasty may be a reasonably good treatment option for patients with technically favorable lesions, especially in vertebrobasilar atherosclerotic occlusion with medically or PTA only refractory symptoms. Despite a significant complication rate, most of our patients experienced good to excellent clinical outcomes and were free of vertebrobasilar ischemia at late midterm follow-up.
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Parkinson disease (PD) is a common neurodegenerative disease in elderly patients that may be treated with deep brain stimulation (DBS). DBS is an accepted surgical treatment in PD patients <70 years that demonstrates marked improvement in disease symptomology. Patients ≥70 years historically have been excluded from DBS therapy. Our objective is to evaluate the short- and long-term outcomes in patients with PD ≥70 years who underwent DBS at our center. ⋯ DBS is effective in treating elderly patients with PD. Patients experienced improvement in motor function, LEDD, and medication doses per day after DBS. Our results suggest that DBS is an effective treatment modality in elderly patients with PD.