Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2009
Case ReportsComa resulting from spontaneous intracranial hypotension treated with the epidural blood patch in the Trendelenburg position pre-medicated with acetazolamide.
A 62-year-old man had a new onset of severe, orthostatic headache which eventually progressed to a stupor and a coma 3 weeks later. A computed tomography (CT) scan showed bilateral chronic subdural haematoma and magnetic resonance imaging (MRI) of the brain showed the typical findings of spontaneous intracranial hypotension (SIH). ⋯ A spinal neuroimaging examination post-EBP is therefore to be recommended in order to confirm the correct execution of procedure. Pre-medication with acetazolamide and keeping the patient in the Trendelenburg position could reduce the flow of spinal cerebrospinal (CSF) leak favouring sealing of the hole.
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Clin Neurol Neurosurg · Oct 2009
Clinical TrialClinical outcome of concomitant chemoradiotherapy followed by adjuvant temozolomide therapy for glioblastaomas: single-center experience.
The use of radiotherapy plus temozolomide administered concomitantly with and after radiotherapy for glioblastoma was recently shown to improve median and 2-year survival in a large international multicenter study. To compare this result in routine clinical practice, an audit of the management and outcome of patients with glioblastoma at our institute was performed. ⋯ This study is the largest study of radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma in Korean patients, who share a common genetic feature. The median and 2-year survival outcomes in this study are comparable to the previous reports. However, for the recurrent glioblastomas refractory to temozolomide, further clinical trials using other agents should be studied continuously in the future.
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Clin Neurol Neurosurg · Oct 2009
Surgical strategies using cerebral revascularization in complex middle cerebral artery aneurysms.
To describe surgical strategies using cerebral revascularization for complex middle cerebral artery aneurysms unsuitable to microsurgical clipping. ⋯ Cerebral revascularization is a safe and effective technique of treatment for selective cases of complex large or giant aneurysms and unclippable fusiform aneurysms in the MCA.
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Clin Neurol Neurosurg · Sep 2009
Case ReportsDelayed coma in head injury: consider cerebral fat embolism.
To describe a case of a young man with delayed coma after mild head injury, suggestive of cerebral fat embolism (CFE). To underline the value of MR imaging in the differential diagnosis of secondary deterioration in mild head injury. ⋯ In head injured patients with long bone fractures one should consider cerebral fat embolism. When the classical clinical syndrome is not present, MR imaging is warranted for diagnosis and to exclude other causes of secondary deterioration.