World Neurosurg
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The goal of this study was to assess the indications of revision for vagal nerve stimulation at a single institution in an adult population with drug-resistant epilepsy. ⋯ VNS implantation in adults was shown to be a well-tolerated procedure. In addition, indications for revision or removal of the VNS device was low in this population with lead fracture rates lower than the incidence reported in pediatric population literature.
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We present an unusual case of hypophyseal involvement in a boy with acute lymphoblastic leukemia via magnetic resonance imaging findings. In our case, the acute lymphoblastic leukemia of the pituitary gland was accurately distinguished from a pituitary adenoma by contrast-enhanced dynamic hypophysis magnetic resonance imaging studies.
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Epidermoid cysts within the sylvian fissure are extremely rare. Expressive aphasia and neurocognitive dysfunction because of mass effect have never been reported previously. ⋯ Although rare, epidermoid cysts of the dominant sylvian fissure can present with progressive aphasia due to mass effect on the arcuate fasciculus. Despite the long-standing symptoms, surgical resection can lead to their complete resolution.
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Aneurysmal subarachnoid hemorrhage (aSAH) is often complicated by the occurrence of delayed ischemic neurologic deficits (DIND), which impairs the clinical outcome of patients. The release of oxyhemoglobin (oxyHb) from lysing erythrocytes into cerebrospinal fluid (CSF) may critically contribute to the development of DIND. ⋯ OxyHb levels in CSF may be useful as a biomarker to predict DIND in aSAH patients. The contribution of oxyHb in CSF to the pathogenesis of DIND should be further investigated as a potential therapeutic target.
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Top performing neurosurgeons and elite athletes require years of sacrifice, discipline, and dedication to their art to be finely attuned to their physical abilities and limitations, and a singular mental focus to reach their full potential under moments of pressure. ⋯ Maintaining peak performance for a neurosurgeon may prove to be more challenging than that of the elite athlete.