Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2016
Multicenter StudyIntracranial angiomatous meningiomas: A 15-year, multicenter study.
Angiomatous meningiomas (AMs) represent a rare subtype of meningiomas in which the vascular component prevail. They represent less than 1% of all intracranial tumors and approximately 2.1% of all meningeal tumors (Hasselblatt et al., 2004). The purpose of this study was to determine the clinical characteristics, radiological features and prognosis of AMs based on a Tunisian multicenter experience in the management of 58 successive cases of intracranial AMs. To the best of our knowledge, this is the largest series reported to date. ⋯ AMs represent a rare subtype of meningioma characterized by variable cystic components, large peritumoral edema and multiple areas of vascular signal voids. The mainstay of the treatment is gross total resection, ideally following a preoperative embolization. The fate of the tumor remnant after incomplete tumor resection still needs to be evaluated and we do not recommend the systematic use of post-operative adjuvant RT in all cases. As local recurrence can develop many years after initial treatment, Long-term follow-up is mandatory.
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Successful use of high-dose fluorescein-sodium (20mg/kg) with a standard light microscope for resection of high-grade gliomas, meningiomas, hemangioblastoma and metastases was reported. The principle of brain tumor staining by fluorescein-sodium (Fl-Na) consists in the accumulation of fluorescein in brain tumors with impaired blood-brain barrier. The aim of our study was to investigate for the first time the usefulness of high-dose fluorescein in patients operated on for benign neuroepithelial brain tumors (grade I WHO tumors) with contrast enhancement on magnetic resonance imaging. ⋯ High doses intravenous Fl-Na seems to be a useful intraoperative technique for delineation of benign neuroepithelial brain tumors with contrast enhancement. Further larger studies may reveal the real value of high doses Fl-Na as intraoperative method for increasing the extent of resection in these particular indications.
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Clin Neurol Neurosurg · Oct 2016
Time course of cerebrospinal fluid inflammatory biomarkers and relationship to 6-month neurologic outcome in adult severe traumatic brain injury.
Activation of the inflammatory cascade is a known pathophysiologic process in severe traumatic brain injury (TBI) with yet non-standardized scientific data regarding relationship to outcome. The understanding of the time course of expression of cerebrospinal fluid (CSF) biomarker levels following severe TBI is an important step toward using these biomarkers to measure injury severity and/or early response to therapeutic interventions. The objective of the current study is to report the time course and values of a battery of CSF inflammatory biomarkers following severe TBI in our reasonably sized patient cohort. ⋯ The study shows that inflammatory biomarkers in CSF are potential biomarkers of injury severity and progression and/or recovery; they could prove beneficial in the future assessment of injury severity and response to therapy after severe TBI.
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Clin Neurol Neurosurg · Oct 2016
Benefits of subthalamic stimulation for elderly parkinsonian patients aged 70 years or older.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an accepted treatment for advanced Parkinson disease (PD). However, there is general reluctance in considering this therapy for PD patients over age 70 years with limited supporting evidence. Present study investigates age impacts in STN-DBS outcomes, focusing particularly on the elderly patients. ⋯ STN-DBS therapy is beneficial to some elderly PD patients aged 70 years or older. Tremor, axial dysfunctions and drug-induced dyskinesia are the main indications for the elderly; however, their clinical benefits are inferior to those of younger patients.
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Clin Neurol Neurosurg · Oct 2016
Familial occurrence of headache disorders: A population-based study in mainland China.
Headache disorders are highly prevalent worldwide, and familial occurrence and heredity are contributory factors attracting the interest of epidemiological researchers. Our purpose, in a large sample drawn nationwide from the Chinese general population, was to evaluate the frequency of similar headache in first-degree relatives (FDRs) of those with different headache types. ⋯ Headache was highly prevalent in China and common among FDRs of those with any type of headache (headache on ≥15 days/month>migraine>TTH). Against the background of the general-population prevalence of each disorder, familial occurrence was a very highly influential factor in headache on ≥15 days/month. There are important implications in this for public health and education.