World Neurosurg
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The objective of this paper is to discuss relevant data on the epidemiology of hydrocephalus in neurocysticercosis, the new knowledge coming from experimental studies, the pathophysiological mechanisms involved, and the controversies regarding clinical and surgical management, through a comprehensive review of the literature. Hydrocephalus is present at the onset of the disease in 16% to 51% of patients with neurocysticercosis and in 64% to 72% of patients with the extraparenchymal form of the disease. Animal models have successfully reproduced the disease and open new therapeutic approaches perspectives. ⋯ In conclusion, mechanical obstruction and inflammation are the key pathophysiologic mechanisms in the development of neurocysticercosis-induced hydrocephalus. Anthelmintic drugs and surgical options should be used, but they have limitations. A better understanding of the disease can come from experimental models.
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Case Reports
Leptomeningeal carcinomatosis following neoplastic cerebral aneurysm rupture: a case report.
Several possible mechanisms exist for the spread of a primary tumor to the leptomeninges in leptomeningeal carcinomatosis. This report describes a case caused by direct bleeding in the subarachnoid space from a neoplastic cerebral aneurysm rupture. ⋯ Tumor cells reach the leptomeninges via hematogenous spread or direct extension from preexisting lesions and can undergo neuraxis dissemination via the cerebrospinal fluid. Subarachnoid hemorrhage and leptomeningeal carcinomatosis are both devastating conditions with extremely poor prognoses. This patient experienced delayed disturbed consciousness leptomeningeal carcinomatosis with decreased performance status, which made it difficult to justify aggressive treatment on the basis of her poor prognosis.
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Case Reports
Use of Pterional Craniotomy for Removal of Penetrating Object: Video Submission and Case Report.
Penetrating injuries are dangerous because they can damage intracranial structures. Removal of the object carries this same risk of injury, so neurosurgeons often visualize the injury via craniotomy during removal. ⋯ The patient progressed well without complications postoperatively and was discharged 5 days later. We provide a report with video showing our surgical approach for removal of a penetrating object through the tuberculum sellae.
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Randomized Controlled Trial
The utility of diagnostic transforaminal epidural injection in selective percutaneous endoscopic lumbar discectomy for multi-level disc herniation with mono-radicular symptom: a prospective randomized control study.
The aim of this study was to analyze the clinical outcomes of diagnostic transforaminal epidural injection (DTEI) in selective percutaneous endoscopic lumbar discectomy for multilevel disc herniation with monoradicular symptom. ⋯ DTEI can improve the clinical outcomes of selective percutaneous endoscopic lumbar discectomy for multilevel disc herniation with monoradicular symptom, through improving the accuracy of confirmation of responsible level.
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Neuronavigation procedures demand high precision and accuracy. Despite this need, there are still few studies analyzing errors in such procedures. The aim of this study was to use a custom-built cranial phantom to measure target position and orientation errors in different phases of a simulated neuronavigation procedure. ⋯ After a stepwise analysis, registration and mechanical execution were the main contributors to the global position error.