World Neurosurg
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Reduced baroreflex sensitivity (BRS) has been reported in patients with acute cardiovascular events. We tested the hypothesis that BRS is substantially reduced in patients with spontaneous intracerebral hemorrhage (ICH) and that BRS can predict treatment outcomes. ⋯ Based on our results, BRS value at admission is a more powerful predictor of outcome than the Glasgow Coma Scale score at admission. An assay of BRS could be added as a biomarker for outcome prediction among patients with spontaneous ICH in clinical practice.
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Spinal arachnoid cysts (SACs) are filled with cerebrospinal fluid, and they include the arachnoid membrane, making it difficult to distinguish the walls of the cyst from the arachnoid membrane and excise the cyst as a lump. Here we report a technique for the intraoperative visualization of SACs, involving the use of pyoktanin blue. ⋯ Our technique of pyoktanin blue injection into SACs could make their excision easy and safe.
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Case Reports
Microscopic minimally invasive keyhole technique for surgical resection of spinal dumbbell tumors.
Multiple surgical modalities have been developedl and applied for surgical excision of spinal dumbbell tumors. The microscopic minimally invasive keyhole technique has not yet been well characterized for this purpose. We report our experience with 1-stage surgical resection of both intraforaminal and extraforaminal/paraspinal components of spinal dumbbell tumors using the microsurgical keyhole technique. ⋯ The microscopic minimally invasive keyhole technique can be used successfully for resection of spinal dumbbell tumors. Further comparative studies are warranted to demonstrate the benefits of the microsurgical keyhole technique compared with traditional open procedures for surgical resection of spinal dumbbell tumors.
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The Simpson grading system has played an important role in surgical resections of meningiomas. The aim of this study was to determine if this grading system predicts meningioma recurrence in a modern cohort of patients with tumors of all World Health Organization grades. ⋯ Identification and consideration of factors associated with recurrence after gross total or subtotal resections may help guide treatment strategies for patients with meningiomas.
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Staged angioplasty for carotid artery stenosis has been reported to be effective in preventing postoperative cerebral hyperperfusion syndrome (CHS) in patients with severe carotid stenosis; thus, it is also recommended for patients with internal carotid artery (ICA) pseudo-occlusion, the treatment strategy for which is controversial. ⋯ Besides preventing CHS, staged angioplasty has advantages when used for treating patients with ICA pseudo-occlusions in that the extent of dilation of the distal ICA after percutaneous transluminal angioplasty can be confirmed and the development of a possible hemorrhagic infarction can be assessed before stent placement.