World Neurosurg
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Review Case Reports
Cerebral venous sinus thrombosis following second transsphenoidal surgery--report of a rare complication and review of literature.
Cushing disease, induced by a pituitary adrenocorticotropic hormone (ACTH)-secreting adenoma, is associated with high risk of stroke. At present, transsphenoidal surgery remains the first line of therapy. Cerebral venous sinus thrombosis (CVST) is an uncommon form of stroke with variable presentations. There are no previous reports of its occurrence in patients with Cushing disease following transsphenoidal surgery. ⋯ In view of the poor outcome of untreated CVST, symptoms such as severe headache, nausea and vomiting, and cerebrospinal fluid leakage after transsphenoidal surgery could be of valuable assistance in early diagnosis, allowing immediate medical intervention with consequent improved prognosis.
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Multicenter Study
Microsurgical treatment of ruptured intracranial aneurysms in sub-Saharan Africa: a series of 102 consecutive cases treated in Senegal.
In sub-Saharan Africa, the management of ruptured intracranial aneurysms (RIAs) is difficult for many reasons. In this retrospective, 3-year study, the authors will demonstrate the particularities of the management of RIAs in Senegal. ⋯ This study demonstrates encouraging results if one refers to the global patient postoperative outcomes. However, the large number of patients not undergoing treatment also requires us to improve preoperative management conditions.
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Hyponatremia is the most common electrolyte abnormality in patients with aneurysmal subarachnoid hemorrhage (aSAH). Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and cerebral salt wasting (CSW) are the most common etiologies. Whether or not the location of the ruptured aneurysm is associated with the etiology of hyponatremia is unknown. We sought to determine whether or not the incidence of SIADH and CSW after aSAH differed based on aneurysm location. ⋯ SIADH is much more common than CSW in patients with aSAH. Anterior circulation aneurysms may be associated with a higher rate of SIADH than posterior circulation aneurysms.
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Comparative Study
Surgical resection of anterior and posterior butterfly glioblastoma.
Evidence suggests a survival benefit for patients with glioblastoma who undergo maximal safe surgical resection. Not all glioblastomas are amenable to surgical resection and anatomic location is one potentially limiting factor. Glioblastomas that invade the corpus callosum and cross midline to the contralateral hemisphere-butterfly glioblastomas (bGBMs)-are one subgroup of tumors traditionally deemed inoperable. ⋯ Surgical resection of butterfly glioblastoma prolongs survival without increased risk of permanent neurologic deficit. Both anterior and posterior bGBMs can be resected safely.
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Craniovertebral junction (CVJ) meningiomas are one of the most surgically complex conditions in neuro-oncologic surgery. The aim of this work is to correlate our data with clinical outcome to outline factors leading to a worse functional prognosis. ⋯ We selected, in our experience, some predictors of worse outcome: preoperative sphincter impairment, absence of a capsule, cranial site of origin, a poor preoperative functional status, and firm consistency of the tumor.