Journal of neurosurgery
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Journal of neurosurgery · Oct 2012
Prognosis of patients with multifocal glioblastoma: a case-control study.
The prognosis of patients with glioblastoma who present with multifocal disease is not well documented. The objective of this study was to determine whether multifocal disease on initial presentation is associated with worse survival. ⋯ Patients with newly diagnosed multifocal glioblastoma on presentation experience significantly worse survival than patients with solitary glioblastoma. Patients with multifocal tumors continue to pose a therapeutic challenge in the temozolomide era and magnify the challenges faced while treating patients with malignant gliomas.
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Dr. George W. ⋯ His contributions to neurosurgery were unfortunately truncated by his untimely death. This article highlights his career and his contributions.
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Journal of neurosurgery · Oct 2012
Comparative StudyEffects of carotid artery stenosis treatment on blood pressure.
The purpose of this study was to evaluate and compare the long-term effects of carotid endarterectomy (CEA) and carotid artery stenting (CAS) on blood pressure (BP). ⋯ Both CEA and CAS have BP-lowering effects. Carotid artery stenting seems to have a better effect than CEA on BP at the 1-year follow-up.
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Journal of neurosurgery · Oct 2012
The prognostic significance of traumatic brainstem injury detected on T2-weighted MRI.
Magnetic resonance imaging is frequently used to evaluate patients with traumatic brain injury in the acute and subacute setting, and it can detect injuries to the brainstem, which are often associated with poor outcomes. This study was undertaken to determine which MRI and clinical factors provide prognostic information in patients with traumatic brainstem injuries. ⋯ Bilateral injury to the pons and medulla as detected on T2-weighted MRI sequences was associated with poor outcome in patients with brainstem injuries; T2 volumes were found superior to gradient echo sequences in regard to predicting survival, but neither reached statistical significance. When MRI findings were coupled with clinical examination findings, a strong correlation existed between poor outcome and the combination of bilateral brainstem injury and a motor GCS score of 4 or less 24 hours after admission.
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Journal of neurosurgery · Oct 2012
Early induction of hypothermia for evacuated intracranial hematomas: a post hoc analysis of two clinical trials.
The authors hypothesized that cooling before evacuation of traumatic intracranial hematomas protects the brain from reperfusion injury and, if so, further hypothesized that hypothermia induction before or soon after craniotomy should be associated with improved outcomes. ⋯ Induction of hypothermia to 35°C before or soon after craniotomy with maintenance at 33°C for 48 hours thereafter may improve outcome of patients with hematomas and severe traumatic brain injury. Clinical trial registration no.: NCT00178711.