World Neurosurg
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Review Meta Analysis
Confirming diagnosis and effective treatment for rare epithelioid glioblastoma variant: an integrated survival analysis of the literature.
Epithelioid glioblastoma (eGBM) is a very rare histologic variant of glioblastoma that has not been studied in isolation and, therefore, its optimal management has been largely assumed, but not confirmed. The aim of this study was to analyze all reported cases describing the presentation and clinical features to better understand the clinical significance of this histologic diagnosis. ⋯ These findings indicate that the histologic diagnosis of eGBM does not deviate from the clinical course of the broader glioblastoma diagnosis, despite being a unique histologic identity. These results argue against the temptation to deviate from the traditional management paradigm of surgery, radiation, and chemotherapy for glioblastoma based on this histology alone.
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Aneurysmal subarachnoid hemorrhage (aSAH) is an acute cerebrovascular disease with frequent cerebral vasospasm and delayed cerebral ischemia (DCI). The use of statins for patients with aSAH is controversial. The present study evaluated the efficacy of statins in aSAH-induced vasospasm, DCI, delayed ischemic neurological deficit (DIND), mortality, and other outcomes. ⋯ Statins significantly reduced the incidence of vasospasm, DIND, DCI, and mortality in individuals with aSAH, suggesting its efficacy in aSAH.
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Atlantoaxial subluxation caused by Brucella infection is rarely seen in children. ⋯ Atlantoaxial dislocation and instability develops secondarily to paravertebral abscesses, only rarely. Like brucellosis of childhood, granulomatous infectious diseases rarely cause atlantoaxial subluxation or dislocation. Torticollis and neck pains should be taken seriously for the purpose of early diagnosis of patients at risk in endemic regions. Stabilization and fusion should be performed when instability is detected, and these patients should be assessed with both pediatric infectious diseases and neurosurgery clinics. Our case is the first one in the literature in which atlantoaxial instability developed due to Brucella infection and stabilization was performed.
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Review Case Reports
Superior oblique myokymia: A case report of surgical treatment, review of the literature, and consideration on surgical approach.
Superior oblique myokymia (SOM) is a rare disorder characterized by episodic microtremor of the eyeball. in patients with SOM, intermittent contraction of the superior oblique muscle causes irregular and rotatory eye movement, causing oscillopsia and diplopia. Microvascular decompression (MVD) of the trochlear nerve is potentially a definitive treatment method for SOM; however, owing to its rarity, this disorder is not well-known to neurosurgeons, and thus the optimal surgical approach has not yet been determined. ⋯ We believe that MVD via a left lateral superior cerebellar approach can be safely performed to SOM in elderly patients like our patient. Therefore, MVD should be considered as the definitive treatment method for more patients with SOM.
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Review Case Reports
Sensorineural Deafness Following Spine Surgery: Case Series and Literature Review.
Sudden sensorineural hearing loss (SNHL) after nonotologic surgery is unusual, with most occurrences reported in patients having cardiopulmonary bypass. Reports of SNHL after nonotologic noncardiac surgery are rare, particularly after spine surgery. In patients undergoing subarachnoid anesthesia or intradural surgery, loss of cerebrospinal fluid pressure can result in hearing loss and cranial nerve palsy. ⋯ Sudden-onset hearing loss post spine surgery is disastrous with multiple etiologies and remains poorly understood. Timely evaluation by an otolaryngologist and audiologist is recommended. The role of corticosteroids in treating SNHL is still unclear.