Journal of neurosurgery
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Journal of neurosurgery · Dec 2014
To fractionate or not to fractionate? That is the question for the radiosurgery of hypoxic tumors.
This study aimed to investigate the impact of tumor hypoxia on treatment outcome for metastases commonly treated with radiosurgery using 1 fraction of radiation and the potential gain from reoxygenation if the treatment is delivered in a few radiation fractions. ⋯ This study shows that hypoxia worsens the response to single-fraction radiosurgery, especially for large tumors. However, fractionated therapy for large hypoxic tumors might considerably improve the TCP and might constitute a simple way to improve the outcome of radiosurgery for patients with hypoxic tumors.
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Journal of neurosurgery · Dec 2014
Case ReportsEncephaloduroarteriosynangiosis for cerebral proliferative angiopathy with cerebral ischemia.
Cerebral proliferative angiopathy (CPA) is a rare clinical entity. This disorder is characterized by diffuse vascular abnormalities with intermingled normal brain parenchyma, and is differentiated from classic arteriovenous malformations. The management of CPA in patients presenting with nonhemorrhagic neurological deficits due to cerebral ischemia is challenging and controversial. ⋯ Follow-up angiography studies obtained 7 months after the operation showed profound neovascularization through the superficial temporal artery and the middle meningeal artery. A SPECT study showed slight improvement of hypoperfusion at the focal region around the right motor area, indicating clinical improvement from the operation. The authors conclude that EDAS may be a treatment option for CPA-related hypoperfusion.
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Journal of neurosurgery · Dec 2014
Trends and outcome predictors after traumatic brain injury surgery: a nationwide population-based study in Taiwan.
The authors sought to analyze trends in hospital resource utilization and mortality rates in a population of patients who had received traumatic brain injury (TBI) surgery. ⋯ These data reveal an increased prevalence of TBI, especially in older patients, and an increased hospital treatment cost but a decreased in-hospital mortality rate. Health care providers and patients should recognize that attributes of the patient and of the hospital may affect hospital resource utilization and the mortality rate. These results are relevant not only to other countries with similar population sizes but also to countries with larger populations.
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Journal of neurosurgery · Dec 2014
Co-prevalence of other tumors in patients harboring pituitary tumors.
The cause of most pituitary tumors remains unknown, although a genetic contribution is recognized for some. The prevalence of pituitary tumors in the general population is high. Analyzing the Utah Population Database (UPDB), the authors investigated the co-prevalence of other independent primary tumors in patients with known pituitary tumors, both benign and malignant, and in the relatives of these patients. ⋯ This information will prove useful for counseling patients in whom pituitary tumors have been diagnosed and suggests strong genetic or environmental co-risks for the development of other tumors.
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Journal of neurosurgery · Dec 2014
Leksell Gamma Knife radiosurgery of the jugulotympanic glomus tumor: long-term results.
Glomus tumors usually display indolent behavior, and the effectiveness of radiation in stopping their growth can be assessed after long-term follow-up. Currently only midterm results of radiosurgery are available, so the authors included patients treated by Gamma Knife at least 10 years ago in this study to obtain a perspective of long-term results. ⋯ Radiosurgery has proved to be a safe treatment with a low morbidity rate and a reliable long-term antiproliferative effect.