World Neurosurg
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Chronic subdural hematoma is a common neurosurgical disease and the most benign form of intracranial hematoma. Most patients are successfully treated with simple burr hole evacuation and external drainage with good outcome and low rate of complications. Brainstem hemorrhage is a rare cause of severe disability in these patients, and cannot be ignored. ⋯ Neurosurgeons must have awareness of remote intracerebral hemorrhage after burr hole evacuation of chronic subdural hematoma, and take measures to avoid it during surgery. Our experience and the review of the relevant literature demonstrate that preoperative computed tomography can provide information to identify the patients at major risk.
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Pseudoaneurysms (PAs) of the extracranial vertebral artery (VA) are rare lesions, representing less than 1% of all aneurysms. Although these lesions may resolve spontaneously, they present a high rupture rate, so early preventive treatment is advised. ⋯ The use of flow diverters seems to be a safe and effective therapeutic option for the treatment of PAs of the extracranial VAs.
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Serum hyperglycemia and hypophosphatemia have been reported to be common in patients with aneurysmal subarachnoid hemorrhage (aSAH). This study aimed to explore whether admission serum glucose-phosphate ratio was associated with the severity and prognosis of aSAH. ⋯ The study shows that the glucose-phosphate ratio is a potential biomarker that can reflect disease severity and prognosis in aSAH patients.
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Primary melanocytic neoplasms (PMNs) are rare neoplasms, especially within the central nervous system. Meningeal melanocytomas, a subtype of PMN, are even rarer. Nevus of Ota results from the incomplete migration of melanocytes from the neural crest. Synchronous nevus of Ota and meningeal melanocytoma are infrequently encountered in clinical practice. ⋯ Our findings indicated a trend for both types of lesion to be located ipsilaterally and supratentorially. When a patient with nevus of Ota is found to harbor an intracranial neoplasm, the most likely diagnosis is PMN.
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Accurate survival estimate is necessary when determining the most appropriate treatment modality for metastatic spinal tumor. The main purpose of this study was to identify the prognostic factors of spinal metastasis and establish a decision tree model. ⋯ A new decision tree model for prognosis prediction in spinal metastasis was established with a satisfactory accuracy and consistency. However, the Tokuhashi and Tomita systems were presented to be less correlated between the scores and actual survival.