Journal of neurosurgery
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Journal of neurosurgery · Oct 2012
Case ReportsIntermuscular lipoma of the gluteus muscles compressing the sciatic nerve: an inverted sciatic hernia.
The authors report the case of a 50-year-old woman with a benign intermuscular lipoma of the gluteus compressing the sciatic nerve in its course through the sciatic notch. This benign soft-tissue tumor extended into the pelvis, displacing the rectum laterally. ⋯ This report features a curious case of soft-tissue tumor growth across the sciatic foramen forming an inverted sciatic hernia. The authors' proposed approach was simple and safe and avoided a laparotomy.
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Journal of neurosurgery · Oct 2012
ReviewDecompressive hemicraniectomy for malignant middle cerebral artery territory infarction: is life worth living?
Although decompressive hemicraniectomy has been shown to reduce death and improve functional outcome following malignant middle cerebral artery territory infarction, there is ongoing debate as to whether surgery should be routinely performed, considering the very high rates of disability and functional dependence in survivors. Through a systematic review of the literature, the authors sought to determine the outcome from a patient's perspective. ⋯ Despite high rates of physical disability and depression, the vast majority of patients are satisfied with life and do not regret having undergone surgery.
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Journal of neurosurgery · Oct 2012
A radiopathological classification of dural tail sign of meningiomas.
The completeness of meningioma resection depends on the resection of dura mater invaded by the tumor. The pathological changes of the dura around the tumor can be interpreted by evaluating the dural tail sign (DTS) on MRI studies. The goal of this study was to clarify the pathological characteristics of the DTSs, propose a classification based on the histopathological and radiological correlation, and identify the invasive range of tumor cells in different types of DTS. ⋯ Nodular-type DTS on MRI studies might be associated with non-Grade I tumors. The range of dural resection for convexity meningiomas should be 2.5 cm from the tumor base, and if this extent of resection is not feasible, the type of DTS should be considered. However, for skull base meningiomas, in which mostly Simpson Grade II resection is achieved, the use of this classification should be further validated. The classification of DTS enables the surgeon to predict preoperatively and then to achieve the optimal range of dural resection that might significantly reduce the recurrence rate of meningiomas.
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Journal of neurosurgery · Oct 2012
ReviewThe role of decompressive craniectomy in cerebral venous sinus thrombosis.
Studies on the role of decompressive craniectomy for cerebral venous sinus thrombosis (CVST) in the literature are scanty. Randomized trials face a lot of drawbacks, including ethical issues. In this article the authors discuss their experience with this procedure for CVST and review the available literature. ⋯ Decompressive craniectomy in a selected cohort of patients had a good outcome in a majority of the patients: 26 of 34 in this study had a GOS score of 4 or 5. In this series, which is the largest in the available literature, the authors review their experience and recommend usage of this procedure in selected patients.