World Neurosurg
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The telemedicine program in Albania includes a specialized teleneurotrauma program. There is only 1 national trauma center with neurosurgery capability in the capital city of Tirana. Patients with isolated head or spine injury who require consultation with neurosurgeons located at the National Trauma Center receive telemedicine consultation. The aim of this follow-up study was to evaluate the effectiveness of a nationwide teleneurotrauma network in preventing unnecessary transfers for neurotrauma. ⋯ Structured and coordinated telemedicine for neurotrauma increases access to care for neurosurgery patients in countries that do not have widespread neurosurgery services. Nearly 70% of patients may be treated locally by nonneurosurgeons.
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The optimal treatment of brain metastases recurring after radiosurgery (BMRS) remains an area of active investigation. Stereotactic laser ablation (SLA, also known as laser interstitial thermal therapy) has recently emerged as a potential treatment option. ⋯ Our analysis provides support for continued development of SLA as a treatment of BMRS. Standardization of periprocedural management will be needed.
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Cardiac myxomas are benign cardiac neoplasms that can send a shower of emboli to cerebral arteries and cause cerebrovascular complications including large, fusiform intracranial aneurysms. These aneurysms result from myxomatous cells invading and weakening the vessel wall and can develop years after myxoma resection. In this clinical image, we illustrate a symptomatic, giant fusiform aneurysm that was discovered and treated 5 years after successful surgical resection of atrial myxoma.
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Case Reports
A rare high-grade glioma with a histone H3 K27M mutation in the hypothalamus of an adult patient: a case report.
Diffuse midline glioma H3 K27M mutant is a new tumor entity described in the revised 2016 World Health Organization classification. It is most frequently observed in children and develops in midline structures, including the brainstem, thalamus, and spine. We describe a rare diffuse midline glioma with an H3 K27M mutation arising in the hypothalamus of an adult. ⋯ Diffuse midline glioma with an H3 K27M mutation occurring in the hypothalamus of an adult is rare but should be considered in differential diagnoses. Because histone H3 K27M mutations are associated with aggressive clinical behavior and poor prognosis, molecular analyses should be used to determine the clinical and histopathologic features of such tumors. This will contribute to developing targeted drugs and gene therapy going forward.