World Neurosurg
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Comparative Study
Decompressive Craniectomy: A preliminary study of comparative radiographic characteristics predicting outcome in Malignant Ischemic Stroke.
Decompressive craniectomy (DC) has been advocated as a lifesaving procedure in management of patients with raised intracranial pressure due to malignant ischemic stroke (MIS). The aim of this study was to identify comparative radiologic parameters after DC to predict functional outcome at 6 months in patients with MIS. ⋯ The comparative radiographic characteristics of absence of effacement of cortical sulci, hemorrhagic transformation, and compression of the lateral ventricles after DC in patients with MIS bore a significant relationship to predicting clinical outcome at 6 months.
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Primary intraventricular hemorrhage (PIVH) is rare, and causes, characteristics, and outcomes remain unknown in children. ⋯ Arteriovenous malformations were diagnosed in most pediatric patients with PIVH. Specific surgical treatment of underlying etiologies should be required to increase clinical improvement. Children with a higher Graeb score at admission tended to have poor early and late outcomes.
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Case Reports
Pseudohypoxic Brain Swelling Following Uncomplicated Lumbar Decompression and Fusion for Spondylolisthesis.
Pseudohypoxic brain swelling (PHBS), also known as postoperative intracranial hypotension-associated venous congestion, is a rare complication after neurosurgery characterized by rapid and often severe postoperative deterioration in consciousness and distinct imaging findings on brain magnetic resonance imaging. Imaging findings associated with PHBS include computed tomography and magnetic resonance imaging findings that resemble hypoxic changes and intracranial hypotensive changes in basal ganglia and thalamus, telencephalic, and infratentorial regions without notable changes in intracranial vasculature. ⋯ Spine surgeons should be alerted to the possibility that PHBS may occur in patients even after an operation without known durotomy or cerebrospinal fluid leakage and with spontaneous clinical resolution unrelated to suction drainage changes or epidural blood patches.
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To assess the association of degree of contrast stasis in intracranial aneurysms (IAs) immediately after Pipeline embolization device (PED; Medtronic, Dublin, Ireland) deployment with 6- and 12-month angiographic occlusion rates. ⋯ The degree of aneurysm contrast stasis immediately after PED deployment is not statistically associated with 6- and 12-month angiographic occlusion rates.
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Pilocytic astrocytoma (PA) is rare in adults comprising 5.1% of the primary central nervous system tumors. The aim is to describe the first Brazilian series of adult patients with PA and compare its features with the available literature. ⋯ This is the first Brazilian series regarding adults with PA, and our patients had a favorable outcome as reported in recent literature reviews. The tumor's prevalence reduces within older patients and supratentorial lesions are more frequent, especially on the temporal lobe. There was no significant relationship between location and progression, although according to the literature the extent of resection remains the most important prognostic factor.