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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Sixty-four-row multislice computed tomographic angiography (CTA) has great potential for use in vascular studies. The aim of our study was to compare 64-slice CTA with three-dimensional rotational angiography (3DRA) in the detection and characterization of intracranial aneurysms with special attention to smaller (<3-mm) aneurysms. ⋯ Sixty-four-slice CTA is a highly accurate imaging examination of the first-line imaging technique for detecting and characterizing intracranial aneurysms including <3-mm aneurysms.
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Placement of ventriculoperitoneal shunt is a well-accepted neurosurgical procedure for the management of obstructive hydrocephalus. The purpose of this study is to evaluate our long-term experience in the management of obstructive hydrocephalus in adult patients with ventriculoperitoneal shunts. ⋯ The results of this retrospective study show that ventriculoperitoneal shunting is effective in the management of adult patients with obstructive hydrocephalus. The overall incidence of shunt revision was comparable with previously reported studies in the literature. However, the high proportion of patients experiencing shunt failure after shunt placement is still a concern.
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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.
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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.