Journal of neurosurgery
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Journal of neurosurgery · Mar 2006
Clinical TrialThe impact of hypotension due to the trigeminocardiac reflex on auditory function in vestibular schwannoma surgery.
Surgical manipulation of the fifth cranial nerve during its intra- or extracranial course may lead to bradycardia or even asystole as well as arterial hypotension, a phenomenon described as the trigeminocardiac reflex (TCR). The authors studied the impact of this reflex on postoperative auditory function in patients undergoing vestibular schwannoma (VS) surgery. ⋯ The hypotension following TCR is a negative prognostic factor for hearing preservation in patients undergoing VS surgery. Patients' knowledge of this can be increased pre- and postoperatively. Further study of this phenomenon will advance the understanding of the underlying mechanisms and may help to improve hearing preservation by controlling the occurrence of the TCR.
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Journal of neurosurgery · Mar 2006
Clinical TrialDynamic perfusion computerized tomography in cerebral vasospasm following aneurysmal subarachnoid hemorrhage: a comparison with technetium-99m-labeled ethyl cysteinate dimer-single-photon emission computerized tomography.
The aim of this study was to correlate cerebral blood flow (CBF) and mean transient time (MTT) measured on dynamic perfusion computerized tomography (CT) with CBF using (99m)Tc ethyl cysteinate dimer-single-photon emission computerized tomography (SPECT) in patients with cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH). ⋯ Relative CBF and MTT values on perfusion CT showed a high concordance rate with estimated relCBF on SPECT in patients with vasospasm following aneurysmal SAH. Given its logistical advantages, perfusion CT may be a valuable method of assessing perfusion abnormality in the acute setting of vasospasm and in patients with an unstable condition following aneurysmal SAH.
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Journal of neurosurgery · Mar 2006
Case ReportsFactor X deficiency presenting as a pseudotumor. Case report.
The authors report their experience in successfully treating a 15-week-old child who became comatose following a spontaneous intracerebral hemorrhage. It was initially believed that a tumor in the right frontal lobe caused the hemorrhage. Coagulation studies revealed abnormal results on presentation, and the problem was only partially corrected after an infusion of fresh frozen plasma. ⋯ Histological analysis of the biopsy specimen revealed normal brain tissue with hemorrhagic infiltration. Subsequently, the child achieved normal developmental milestones. A diagnosis of congenital bleeding disorder should be considered in children with spontaneous intracerebral hemorrhage, even in those with no prior episode of extracerebral spontaneous hemorrhage.
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Journal of neurosurgery · Mar 2006
Coexistence of intracranial and spinal cavernous malformations: a study of prevalence and natural history.
The purpose of this study was to examine the prevalence of intracranial cavernous malformations (CMs) in a large series of predominantly Caucasian patients with spinal cord CMs. The authors also studied the natural history of spinal CMs in patients who were treated nonoperatively. ⋯ As many as 40% of patients with a spinal CM may harbor a similar intracranial lesion, and approximately 40% of patients with coexisting spinal and intracranial CMs may have the nonfamilial (sporadic) form of the disease. Patients with symptomatic spinal CMs who are treated nonoperatively may have a small risk of clinically significant recurrent hemorrhage. The findings will aid in evaluation of surveillance images and in counseling of patients with spinal CMs, irrespective of family history.
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Journal of neurosurgery · Mar 2006
Correlation between the efferent venous drainage of the tumor and peritumoral edema in intracranial meningiomas: superselective angiographic analysis of 25 cases.
The extent of peritumoral brain edema (PTBE) associated with meningiomas can be highly variable. The authors studied the correlation between the development of efferent venous drainage from the tumor and the degree of PTBE that occurs in intracranial meningiomas. ⋯ The current results suggest that hypoplasia of the efferent draining vein from the meningioma itself contributes to PTBE formation. The development of an efferent venous system mitigates against the formation of PTBE. Intratumoral venous congestion can be considered the main cause of PTBE in meningiomas.