World Neurosurg
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Review Meta Analysis
Safety and Efficacy of Endovascular Treatment of Previously Clipped Aneurysms: A Systematic Review and Meta-Analysis.
The safety and efficacy of endovascular treatment of previously clipped aneurysms have not been well-established. We conducted a systematic review of the literature to evaluate the outcomes of endovascular treatment of previously clipped aneurysms. ⋯ Our meta-analysis demonstrated that endovascular treatment is acceptably safe and effective. It is important to point out that the complication rate of treatment of these aneurysms is not negligible. These findings should be considered when deciding the best therapeutic strategy. Our findings may suggest that endovascular treatment of previously clipped aneurysms should only be considered in circumstances in which conservative management seems to be unsafe.
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Review Case Reports
Primary Spinal Malignant Mesothelioma: A Case Report and Literature Review.
Malignant mesotheliomas are aggressive and rapidly fatal neoplasms arising from the mesothelial cells. The most common sites of origin are the pleural and peritoneal cavities; the pericardium and the tunica vaginalis are infrequently involved, and malignant mesothelioma in the spinal canal is extremely rare. Here we report a case of primary spinal malignant mesothelioma. We also report the results of a literature search conducted in PubMed with specific key terms, inclusion criteria, and exclusion criteria, with a comparison of elected case studies and case series, and statistical analysis as appropriate. ⋯ Spinal malignant mesothelioma is an extremely rare but highly aggressive entity. Preoperative identification is challenging, and definitive diagnosis depends on histopathological evidence. Surgical resection can help relieve the symptoms, but the overall prognosis is poor.
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Review Case Reports
Endovascular Recanalization of Occluded Dural Sinus in Patient with Dural Arteriovenous Fistulas: Case Report and Literature Review.
Symptomatic sinus occlusion complicated with dural arteriovenous fistulas (dAVFs) can be treated successfully endovascularly. However, no studies have reported the use of endovascular transvenous approaches alone to recanalize the occluded sinuses for treatment of the involved dAVFs without stent deployment. In this study, we presented a 75-year-old man with occlusion of the transverse and sigmoid sinuses complicated with a dAVF. ⋯ Endovascular transvenous recanalization may be a better alternative therapy for selected patients with dural arteriovenous fistulas complicated by sinus occlusion without stent deployment.
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Piperacillin-tazobactam is common empiric antibiotic therapy. Hematologic laboratory test abnormalities were documented but rare in premarketing studies, and whether these alterations are of clinical significance has been studied little. Very few cases of piperacillin-induced bleeding, thrombocytopenia, or both have been reported; aberrations in platelet function have not been implicated. ⋯ This is unique in that the significant bleeding that occurred was attributable to platelet dysfunction rather than thrombocytopenia. This is the first reported case of intracranial (periprocedural) hemorrhage potentially related to piperacillin-tazobactam; further research into this drug's impact upon qualitative platelet function is needed.
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Traumatic brain injury associated with alcohol consumption is a global public health problem. It is important to identify and rethink the strategies to approach this challenge for health care institutions from a professional perspective. ⋯ These findings confirm a lack of systematic strategies for management of patients with TBI and associated comorbidity of alcohol intoxication in the acute phase. It is important to define specific management guidelines to improve treatment efficacy and limit complications in patients with TBI and alcohol intoxication.