World Neurosurg
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Case Reports
Rare Tumor-to-Tumor Metastases involving Lung Adenocarcinoma to Petroclival Meningiomas.
Lung carcinoma metastasizing to a skull base meningioma remains an extremely rare phenomenon, with only 3 studies reported. Furthermore, no documented cases have been reported in the petroclival region. Thus, we have presented the first 2 cases of tumor-to-tumor metastasis (TTM) in which a petroclival lesion, initially thought to be purely meningioma, was also found to contain metastatic lung adenocarcinoma. ⋯ Skull base TTM is a rare entity for which no specific management guidelines have been created. Therefore, even if the imaging characteristics suggest a more benign process, skull base TTM should remain high on the differential diagnosis for patients with a known primary cancer and new-onset, rapidly progressive, neurologic deficits. Close clinical follow-up with short-interval repeat imaging in this subset of patients might prevent misdiagnosis and facilitate prompt treatment.
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Subarachnoid hemorrhage (SAH) is associated with high morbidity. Among all complications, infections, in particular if hospital acquired, could represent an important cause of death in patients with SAH. The aim of this study was to describe infectious complications in patients with SAH and to evaluate their impact on outcome. ⋯ Infections in patients with SAH are prevalent, especially pneumonia. Septic shock is associated with a poor neurologic outcome in this group of patients.
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Historical Article
Bibliometric Analysis of the Top 100 Most Cited Articles on Intraventricular Hemorrhage.
Intraventricular hemorrhage (IVH) is a rare cause of intracranial bleeding across all age groups, with dismal sequelae in most of the affected population. The reported data on IVH are numerous, with multiple levels of evidence. We performed a citation-based analysis to identify the most-cited reports on IVH. ⋯ The present collection of highly cited studies can aid in the understanding of chronological trends and could serve as an efficient guide to delineate the reports involved in the evidence-based practice of the management of IVH.
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Comparative Study
A Comparison of the Elixhauser and Charlson Comorbidity Indices: Predicting In-Hospital Complications Following Anterior Lumbar Interbody Fusions.
The Elixhauser Comorbidity Index (ECI) and Charlson Comorbidity Index (CCI) are commonly used measures that use administrative data to characterize a patient's comorbidity burden. The purpose of this study was to compare the ability of these measures to predict outcomes following anterior lumbar interbody fusion. ⋯ The ECI was superior to the CCI in predicting 6 of the 15 complications analyzed in this study. Combined with previous results, the ECI may be a better predictive model in spine surgery.
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Patients with good-grade aneurysmal subarachnoid hemorrhage (aSAH) are thought to recover well, yet some do not. This work sought to identify predictors of unfavorable functional outcome after good-grade aSAH. ⋯ About 1 in 5 good-grade aSAH patients enrolled in CONSCIOUS-1 suffered an unfavorable functional outcome. Admission systolic blood pressure, female sex, hyperthermia, delayed cerebral ischemia, respiratory complications, and intracranial hemorrhagic complications may be predictive of outcome.