Journal of neurosurgery
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Journal of neurosurgery · Aug 2012
Intraventricular hemorrhage on computed tomography and corpus callosum injury on magnetic resonance imaging in patients with isolated blunt traumatic brain injury.
Intraventricular hemorrhage (IVH) is widely regarded as one element of a complex involving severe blunt traumatic brain injury (TBI); corpus callosum injury (CCI) is recently considered to be one factor associated with poor outcome in patients with TBI. Although postmortem studies have focused on the relationship between IVH and CCI, there have been few investigations of IVH evidenced on CT scans as a predictor of CCI evidenced on MRI. ⋯ The authors' results suggest that evidence of IVH on CT may indicate CCI, which can lead to disability in patients with isolated blunt TBI.
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Journal of neurosurgery · Aug 2012
Preoperative multimodal motor mapping: a comparison of magnetoencephalography imaging, navigated transcranial magnetic stimulation, and direct cortical stimulation.
Direct cortical stimulation (DCS) is the gold-standard technique for motor mapping during craniotomy. However, preoperative noninvasive motor mapping is becoming increasingly accurate. Two such noninvasive modalities are navigated transcranial magnetic stimulation (TMS) and magnetoencephalography (MEG) imaging. While MEG imaging has already been extensively validated as an accurate modality of noninvasive motor mapping, TMS is less well studied. In this study, the authors compared the accuracy of TMS to both DCS and MEG imaging. ⋯ Maps of the motor system generated with TMS correlate well with those generated by both MEG imaging and DCS. Negative TMS mapping also correlates with negative DCS mapping. Navigated TMS is an accurate modality for noninvasively generating preoperative motor maps.
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Journal of neurosurgery · Aug 2012
Radiosurgery for melanoma brain metastases in the ipilimumab era and the possibility of longer survival.
A prospectively collected cohort of 77 patients who underwent definitive radiosurgery between 2002 and 2010 for melanoma brain metastases was retrospectively reviewed to assess the impact of ipilimumab use and other clinical variables on survival. ⋯ The survival of patients with melanoma brain metastases managed with ipilimumab and definitive radiosurgery can exceed the commonly anticipated 4-6 months. Using ipilimumab in a supportive treatment paradigm of radiosurgery for brain oligometastases was associated with an increased median survival from 4.9 to 21.3 months, with a 2-year survival rate of 19.7% versus 47.2%. This association between ipilimumab and prolonged survival remains significant even after adjustment for performance status without an increased need for salvage WBRT.
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Journal of neurosurgery · Aug 2012
Outcome after severe brain trauma due to acute subdural hematoma.
In this paper, the authors' goal was to identify factors contributing to outcomes after severe traumatic brain injury (TBI) due to acute subdural hematoma (SDH). ⋯ Age, severity of TBI, and neurological status were the main factors influencing outcomes after severe TBI due to acute SDH. Nonoperative management was associated with significantly higher mortality.
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Journal of neurosurgery · Aug 2012
Long-term visual outcome after microsurgical removal of occipital lobe cavernomas.
Cavernomas in the occipital lobe are relatively rare. Because of the proximity to the visual cortex and incoming subcortical tracts, microsurgical removal of occipital cavernomas may be associated with a risk of visual field defects. The goal of the study was to analyze long-term outcome after operative treatment of occipital cavernomas with special emphasis on visual outcome. ⋯ Surgical removal of occipital cavernomas may carry a significant risk of postoperative visual field deficit, and the risk is even higher for deeper lesions. Seizure outcome after removal of these cavernomas appeared to be worse than that after removal in other supratentorial locations. This should be taken into account during preoperative planning.