World Neurosurg
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Hyponatremia in patients with traumatic brain injury: etiology, incidence, and severity correlation.
Hyponatremia is common in patients with traumatic brain injury (TBI). This study aims at ascertaining the incidence of hyponatremia in TBI with its etiologic diagnosis, biochemical confirmation, and severity correlation with initial Glasgow Coma Scale (GCS) score and computed tomography (CT) abnormality. ⋯ Hyponatremia due to SIADH is more common in TBI. FEUA measurement is not consistent enough to make a distinction between SIADH and CSWS. CT scoring of severity is more predictive of hyponatremia than initial GCS.
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To compare intraoperative magnetic resonance imaging (MRI)-guided resection with resection guided by 5-aminolevulinic acid (5-ALA)-induced fluorescence in patients with gliomas and to evaluate the impact of intraoperative MRI in glioma surgery. ⋯ Intraoperative MRI-guided resection is a powerful tool to treat 5-ALA (-) gliomas (mostly low grade), and 5-ALA is useful for high-grade gliomas. The combination of intraoperative MRI and 5-ALA has a synergistic effect in glioma surgery. Additionally, precise tumor grading in preoperative imaging studies can be difficult. Surgery for gliomas should be performed using both 5-ALA-induced fluorescence and intraoperative MRI-guided resection.
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To review the authors' experience with Gamma Knife radiosurgery (GKR) for small recurrent high-grade gliomas (HGGs) following prior radical resection, external-beam radiation therapy (EBRT), and chemotherapy with temozolomide (TMZ). ⋯ GKR provided good local tumor control in this group of clinically stable and predominantly high-functioning patients with small recurrent HGGs after radical resection. Meaningful survival times after GKR were seen. GKR can be considered for selected patients with recurrent HGGs.
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To evaluate the long-term imaging and clinical outcomes of patients with brainstem arteriovenous malformations (AVMs) treated with Gamma Knife surgery (GKS). ⋯ Given the poor surgical outcome of brainstem AVMs, the results of 59% nidus obliteration and 6% permanent neurologic deficits make GKS a reasonable management of these difficult lesions.