World Neurosurg
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Review Case Reports
Intraparenchymal Hemorrhage After Evacuation of Chronic Subdural Hematoma: A Case Series and Literature Review.
Intraparenchymal hemorrhage (IPH), possibly due to reperfusion, after evacuation of a cranial chronic subdural hematoma (cSDH) is a known phenomenon. However, it is sparingly reported and not well understood. ⋯ IPH after cSDH evacuation is associated with significant morbidity and mortality. Prompt recognition, regulating blood pressure, controlling the amount and rate of extra-axial fluid drained, and a meticulous surgical technique are critical to optimize the care of patients with cSDH and reduce the rate of postoperative IPH.
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Review Case Reports
Misdiagnosis and delay of diagnosis in hemorrhagic meningioma: a case series and review of the literature.
To evaluate the clinicoradiologic characteristics of hemorrhagic meningiomas (HMs) that are missed or misdiagnosed on radiologic imaging studies. ⋯ Our study showed that in patients with HM with inadequate imaging evaluation, a small tumor associated with massive hematoma and atypical imaging features was more likely to be misdiagnosed.
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Review
Surgical Excision of Cirsoid Aneurysm of the Scalp: Case Series and Review of the Literature.
Cirsoid aneurysms, also known as arteriovenous malformations (AVMs), of the scalp are relatively rare lesions. They may be found incidentally or with symptoms such as an enlarging pulsatile mass, headache, or bleeding. ⋯ Preoperative embolization reduces vascularity and helps in easy identification as well as complete excision of cirsoid aneurysms during surgery. However, surgical excision alone of cirsoid aneurysms also results in excellent outcomes.
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As the COVID-19 pandemic surpasses 1 year, it is prudent to reflect on the challenges faced and the management strategies employed to tackle this overwhelming health care crisis. We undertook this study to validate our institutional protocols, which were formulated to cater to the change in volume and pattern of neurosurgical cases during the raging pandemic. ⋯ Despite a significant decrease in neurosurgical workload during the COVID-19 lockdown period in 2020, the volume of emergency and essential surgeries did not change much compared with the previous year. Surgery in COVID-19 patients is best avoided, unless critical, as the outcome in these patients is not favorable. The employment of monitored anesthesia care techniques like awake craniotomy and regional anesthesia facilitate a better outcome in the ongoing COVID-19 era.
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To determine whether vertical laminar fracture (VLF) can distinguish between AO type A3 and A4 fractures. ⋯ We found VLF to be highly specific, sensitive, and reliable in detecting A4 fractures. A higher proportion of A4 fractures with VLF had radiographic parameters and neurological deficit than A4 fractures with no VLF. VLF could be used as a severity modifier to further discriminate A3 and A4 fractures regarding severity and potentially guide treatment decision making.