Medicine
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Cardiac arrest (CA) is a life-threatening event with a high mortality rate, and neurological injury following cardiopulmonary resuscitation (CPR) is a leading cause of death and disability in survivors. While prolonged CPR is often associated with poor neurological outcomes, there is limited evidence of successful recovery following extended resuscitation efforts. This study aims to highlight the potential for recovery after prolonged CPR by reporting a case of a patient who underwent 152 minutes of CPR, regained consciousness, and made a full recovery. The purpose is to explore whether advanced life-support techniques, such as extracorporeal CPR (ECPR), can improve survival and neurological outcomes even after prolonged CA. ⋯ This case demonstrates that prolonged CPR, when combined with advanced interventions such as ECPR, can result in favorable outcomes, including survival and neurological recovery. The findings suggest that with timely and appropriate treatment, even patients with extended resuscitation efforts may achieve full recovery, thus underscoring the potential of ECPR as a critical life-saving intervention in cases of prolonged CA.
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Review Case Reports
Imaging features of bronchogenic cyst of the stomach: A case report with literature review.
Bronchogenic cyst (BC) is a congenital disease characterized by an anomaly of the foregut in the embryonic stage. Gastric BC is exceedingly rare and has never been accurately diagnosed prior to surgery; it is often misidentified as gastric stromal tumor, with the definitive diagnosis confirmed through postoperative specimens. Although gastric BC is considered a benign lesion, its prognosis remains uncertain, underscoring the importance of accurate preoperative identification. ⋯ BC of the stomach is mostly ovate in shape with well-defined margins. The cyst wall shows prolonged enhancement and calcification may occur at the edges. The density and signal of the cyst content varied with composition. These imaging features are helpful for differentiating diagnoses from other diseases.
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Review Case Reports
Organized chronic subdural hematoma with cognitive impairment: A case report and literature review.
Organic chronic subdural hematoma is extremely rare in clinical practice, with unclear etiology and pathogenesis. Its clinical manifestations and treatment approaches are diverse, making diagnosis challenging and prone to misdiagnosis or mistreatment, adversely affecting patient care and quality of life. ⋯ Patients with mild or no significant symptoms, such as headaches and dizziness, are advised to undergo regular imaging follow-ups. Surgical intervention is recommended for patients presenting with intracranial hypertension and neurological impairment, with bone flap craniotomy and lesion resection under microscopic guidance being the preferred approach. It is imperative to conduct regular postoperative monitoring to promptly detect potential complications, such as hematoma recurrence.
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Case Reports
Antegrade horizontal stenting for endovascular coiling of wide-neck aneurysms in the basilar tip: Two case reports.
Endovascular coil embolization for wide-neck intracranial aneurysms is technically challenging and requires supporting devices. Intracranial stents are widely used as a buttress for compact coil filling and preventing coil protrusion into the parent artery. Horizontal stenting has been developed to maximize coil insertion and reduce the risk of thromboembolism. An anterograde route for horizontal stenting could be attempted for basilar tip aneurysms if the posterior communicating artery is not accessible. Here, we report 2 cases of antegrade horizontal stenting (AHS) for wide-neck aneurysm (WNA) in the basilar tip. This approach aims to maximize coil insertion and achieve complete aneurysm occlusion. ⋯ Horizontal stenting via an antegrade route may be an effective strategy for achieving compact coil embolization in selected patients with WNAs at the basilar tip. The Neuroform Atlas stent appears to be a promising tool for AHS owing to its hybrid-cell design. However, the shifting phenomenon of a jailed microcatheter after AHS warrants attention, as it may present potential challenges that require further catheterization.
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Observational Study
Neoadjuvant chemoradiation therapy application in radical esophagectomy surgery: Safety and feasibility: A descriptive study in Vietnam.
Esophageal cancer (EC) ranks as the 7th most prevalent form of cancer and the 6th leading cause of cancer-related mortality globally. Neoadjuvant therapy, encompassing neoadjuvant chemotherapy or chemoradiotherapy, has shown promise in reducing the staging of EC and mitigating the risk of early systemic spread. This study seeks to assess the safety and viability of implementing neoadjuvant chemoradiotherapy (nCRT) in conjunction with radical esophagectomy surgery for Vietnamese patients diagnosed with locally advanced EC. ⋯ R0 resection was achieved in 29 (96.7%) patients, with 43.4% attaining pathological complete response and 56.7% demonstrating tumor complete response. The study's outcomes emphasize the safety and feasibility of employing esophagectomy subsequent to nCRT in Vietnamese patients, as evidenced by the absence of mortality, low complication rates, and favorable surgical results. It also suggests the potential advantages of utilizing a lower daily Gy dose for enhanced safety and considering squamous cell carcinoma as a specific criterion for nCRT.