World Neurosurg
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Treatments for intracranial aneurysms mainly include endovascular treatment and craniotomy. Most studies report on large intracranial aneurysms, yet treatments for very small intracranial aneurysms remain controversial. Our purpose was to explore management strategies for ruptured very small intracranial aneurysms. ⋯ Endovascular therapy for ruptured very small intracranial aneurysms was not inferior to surgical clipping and showed a slight trend toward better prognosis.
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Case Reports
Spontaneous Intraventricular Hemorrhage: A Rare Presentation of a Skull Base Mesenchymal Chondrosarcoma.
Chondrosarcomas are very rare malignant, slow-growing tumors that develop in or near the petroclival region of the brain. We report a very rare case in which the tumor originated from left petrous bone and induced intraventricular hemorrhage leading to an acute comatose presentation. ⋯ Our experience of petroclival junction chondrosarcoma causing intraventricular hemorrhage may be the first to be documented. Preferred treatment of this highly malignant lesion is radical removal with postoperative radiotherapy.
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Case Reports
Trigeminal Ganglioneuroma: A rare cause of trigeminal neuralgia caused by cerebello-pontine angle tumor.
Intracranial ganglioneuromas are very rare benign tumors of neural crest origin and generally arise from the peripheral nervous system or adrenal glands. Very few cases of intracranial ganglioneuroma arising from the trigeminal nerve have been reported in the literature, all in East Asia. ⋯ To the best of our knowledge, this is the sixth case of trigeminal ganglioneuroma; however, it is the first case reported in the United States.
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Ruptured intracranial fusiform aneurysms involving small-diameter parent arteries are difficult to treat. Parent artery occlusion is a relatively simple and reliable treatment. However, occasionally, the parent arteries have to be retained. The arrival of the low-profile stent (LVIS Jr.) has made reconstructive endovascular treatment for fusiform aneurysms involving small-diameter parent arteries possible. ⋯ Stenting after a coiling technique using the LVIS Jr. stent provides a possible method for reconstructive endovascular treatment of intracranial fusiform aneurysms with parent arteries <1.5 mm in diameter.
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Case Reports
Is First Line Vancomycin still the Best Option to Treat Staphylococcus healthcare-associated Meningitis?
Cerebrospinal fluid (CSF) penetration of vancomycin through the blood-brain barrier is poor but important inflammation improved it. Hence, vancomycin is recommended for the treatment of community meningitis. However, what about mild inflammatory health care-associated meningitis? The aim of this study was to evaluate the impact of vancomycin diffusion on CSF in Staphylococcus epidermidis health care-associated meningitis. ⋯ We propose to reassess vancomycin use as first-line therapy when meningeal inflammation is mild-to-moderate in favor of antibiotics, which have a better CSF penetration.