World Neurosurg
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Randomized Controlled Trial Comparative Study
Comparison of Haemostatic Gelatin Sponge Impregnated with Ropivacaine versus Normal Saline applied on the Transverse Process of the Operated Vertebrae on Post-Operative Pain in Patients Undergoing Spinal Instrumentation Surgery: A Randomized Clinical Trial.
Protocols for effective postoperative pain control in patients undergoing spinal surgery are not standardized. In our study, we compared the effects of hemostatic absorbable gelatin sponge impregnated with ropivacaine versus normal saline when applied to the transverse process of the operated vertebrae on the postoperative pain following instrumentation spine surgery. ⋯ Use of intraoperative hemostatic gelatin sponge impregnated with ropivacaine applied on the transverse process of the operated vertebrae intraoperatively resulted in decreasing the postoperative pain in patients undergoing lumbar instrumentation surgery as manifested by the decrease in the VAS score and the total dose of opioids.
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Review Case Reports
Secondary diffuse choroid plexus B-cell lymphoma: a case report and review of the literature.
Central nervous system (CNS) relapse is an uncommon complication of diffuse large B cell lymphoma and is associated with significant mortality and morbidity. It is becoming a more prevalent pathologic entity in the rituximab era. Our case provides insight into the pathophysiology, diagnosis, prevention, and management of secondary intraventricular CNS lymphomas. ⋯ This case highlights the lack of high-quality evidence behind the use of high-dose intravenous methotrexate as CNS prophylaxis. The case provides additional insight into the pathophysiology of intraventricular CNS lymphomas and the importance of establishing a histopathologic diagnosis via an open biopsy before the administration of high-dose steroids.
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Review Case Reports
Trigeminal ganglion metastasis of renal clear cell carcinoma: Cases reports and literature review.
The trigeminal ganglion is an atypical site for metastasis, especially for renal clear cell carcinoma. ⋯ In the case of trigeminal symptoms, rapid tumoral growth on brain MRI, or a history of RCC, we think that a body computed tomography should be performed, and surgery should be considered.
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Archaeological evidence of trepanation during the European Bronze Age is numerous and testifies a wide application of neurosurgical practices during prehistory. In some particular cases, trepanation may be associated with other peculiar evidence concerning funerary practices. The aim of this paper is to present the case of a woman from the Recent Bronze Age site of Castello del Tartaro (Verona, Italy), who was buried in a prone position and whose skeletal remains presented evidence of probable frontal trepanation. The association between a deviant burial and trepanation could be of interest in better understanding the history and perception of neurosurgical practices during prehistory.
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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.