World Neurosurg
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This study sought to present an overview of dabigatran, a new anticoagulant, and to discuss the implications for the perioperative management of patients taking dabigatran. ⋯ We present a basic overview of dabigatran, discuss the implications for the perioperative management of patients taking this new anticoagulant, and offer recommendations for the management of intracranial hemorrhage related to this drug.
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Multicenter Study
Outcomes and complications of extension of previous long fusion to the sacro-pelvis: is an anterior approach necessary?
Patients with previous multilevel spinal fusion may require extension of the fusion to the sacro-pelvis. Our objective was to evaluate the outcomes and complications of these patients, stratified based on whether the revision was performed using a posterior-only spinal fusion (PSF) or combined anterior-posterior spinal fusion (APSF). ⋯ Among adults with previously treated scoliosis requiring extension to the sacro-pelvis, PSF produced radiographic fusion and clinical outcomes equivalent to APSF, whereas complication rates may be lower. PSO resulted in greater sagittal plane correction, without an increase in overall complication rates.
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Review Case Reports
Factors influencing the prognosis in intracranial dural arteriovenous fistulas with perimedullary drainage.
Intracranial dural arteriovenous fistulas with perimedullary venous drainage (IDAVFPD) are classified as type V dural arteriovenous fistulas. Publications are limited to single case reports and small case series. We conducted a systematic review of the literature for patients with IDAVFPD. The aim of this study is to identify the predictive factors of poor prognosis in patients with IDAVFPD. ⋯ The poor outcomes were correlated to the presence of brainstem signal abnormalities on magnetic resonance imaging, whereas the prognosis does not depend on age, sex, clinical presentation, or anatomic characteristics of the fistula.
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We sought to (1) describe psychological, physical, and cognitive functions in patients 10 years after intracranial aneurysm rupture and (2) identify any differences in outcome variables between age groups, gender or aneurysm locations. ⋯ Ten years after aneurysm rupture the majority of patients seem to be well-functioning physically, whereas the psychological and cognitive functions are affected. A screening of the mental health of these patients in connection to radiological follow-up might be helpful to identify which patients need further referral to psychiatric treatment for anxiety and depression disorders.
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Review Case Reports
Vertebral brown tumors causing neurologic compromise.
Brown tumors are nonneoplastic lesions that occur only in the setting of hyperparathyroidism. Although vertebral brown tumors are relatively rare pathologic entities, their incidence seems to be on the rise, as evidenced by multiple case reports published during the past four decades. An extensive review of these lesions is lacking in the literature. We present a case of paraparesis secondary to vertebral brown tumor followed by a detailed review of the literature. ⋯ In patients presenting with a lytic vertebral lesion and known hyperparathyroidism or end-stage renal disease, brown tumor should be considered in the differential diagnosis. In select cases with minimal neurologic symptoms, parathyroidectomy may be warranted prior to neurosurgical intervention.