World Neurosurg
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To evaluate the diagnostic value and safety of stereotactic biopsy in acquired immune deficiency syndrome (AIDS) patients with intracranial lesions via meta-analysis. ⋯ Stereotactic biopsy is a safe and effective way of diagnosing intracranial lesions in patients with AIDS. It is helpful for the differential diagnosis and for choosing a suitable therapy. The 4 most common intracranial lesions in patients with AIDS are lymphoma, PML, TE, and HIV encephalitis.
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Acquired Chiari malformations (ACM) and associated syringomyelia secondary to space-occupying lesions can cause neurologic deficits independent of or in combination with the offending mass. Although type I Chiari malformations are traditionally treated with posterior fossa decompression, optimal surgical management of ACM and associated syringomyelia remains unclear. The purpose of this study is to review the current literature surrounding the management of ACM. ⋯ Space-occupying lesions in the posterior fossa are a rare cause of ACM and syringomyelia. Surgical management of the underlying lesion improves ACM and associated syringomyelia without the need for syrinx shunting.
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Pyogenic cerebral ventriculitis is a debilitating form of intracranial infection with an unfavorable outcome as a result of lack of experience in surgical management. ⋯ The results suggest a relatively favorable outcome for management of pyogenic cerebral ventriculitis by NES. The techniques and strategies are practical and should be applied more extensively.
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Review Case Reports
Bilateral Ossified Chronic Subdural Hematoma Presenting As Diabetes Insipidus- A Case Report and Literature Review.
Calcified chronic subdural hematomas are an occurrence rarely seen in neurosurgical clinical practice. And when they occur bilaterally, the radiologic image they present is fascinating, as is the clinical presentation, but their management may be challenging. ⋯ Due to the rarity of this pathology, the management protocol is not well defined, though there have been quite a few papers on this condition. This review article gathers information published over the years on this rare entity to suggest a treatment protocol.
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Multicenter Study
Predictors of shunt insertion in aneurysmal subarachnoid hemorrhage.
Hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage (aSAH), requiring permanent cerebrospinal fluid (CSF) diversion in up to two thirds of patients. Factors that predict permanent CSF diversion are not well established. ⋯ Sympathomimetic illicit drug use, EVD insertion, and hyponatremia are the strongest predictors of shunt insertion in patients with aSAH. Moreover, a scoring system based on EVD insertion, Hunt and Hess grade, and modified Fisher computed tomography grade can reliably predict the need for shunt placement in patients with aSAH.