World Neurosurg
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The use of hyperosmolar agents, such as mannitol or hypertonic saline (HTS), to control high intracranial pressure (ICP) in patients with traumatic brain injury has been well studied. However, the role of HTS in the management of aneurysmal subarachnoid hemorrhage (aSAH)-associated increased ICP is still unclear. ⋯ The current evidence suggests that HTS is as effective as mannitol at reducing increased ICP in aSAH. However, there is not enough data to recommend the optimal and safest dose concentration or whether HTS significantly improves outcomes in aSAH.
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Review Case Reports
Medulloblastoma with atypical dynamic imaging changes: A case report with literature review.
We analyzed a case of medulloblastoma with atypical dynamic imaging changes retrospectively to summarize the atypical magnetic resonance imaging (MRI) features of medulloblastoma by reviewing the literature. ⋯ The radiologic characteristics of atypical medulloblastomas vary in adults and children. Understanding the radiologic characteristics of medulloblastomas, such as MRI features, age of onset, and location of atypical medulloblastomas, can help improve the diagnosis of medulloblastomas.
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Stent-assisted coil embolization and flow diversion with the Pipeline embolization device (PED) are both effective endovascular treatment options for ophthalmic segment aneurysms (OSAs) of the internal carotid artery. Here we present a large comparative cohort study. ⋯ Stent-coiling and the PED were equally effective for treating OSAs. There were no significant differences in terms of procedural complications, angiographic, functional, and visual outcomes. PED may be more favorable for multiple adjacent OSAs.
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Different gene expression profiles are observed in intracranial aneurysm tissues. Understanding these genes and what regulates their expression will provide insight into the pathogenesis of intracranial aneurysms. We investigated whether differences in DNA methylation regulate gene expression in intracranial aneurysms. ⋯ In the development of intracranial aneurysms, DNA methylation plays an important role in the regulation of genetic expression involved in immune and inflammatory reactions, cell function, cell maintenance, and cell signal transduction.
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Decompressive craniectomy (DC) has been proposed as a lifesaving treatment in patients with elevated intracranial pressure, but its effectiveness on reaching a favorable neurologic outcome remains unclear. We identified predictors of outcome in a large, single-center cohort of patients undergoing DC for different pathologic conditions. ⋯ Long-term neurologic outcome after DC differed remarkably among subpopulations of patients, with favorable outcome rates ranging from 0% to >90%.