Neurosurgery
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Review Case Reports
Primary intracranial melanocytic tumor simulating pituitary macroadenoma: case report and review of the literature.
Primary intracranial melanocytic tumors are rare lesions, sellar ones being even more exceptional. So far, six melanomas and two melanocytomas have been described in an intrasellar and/or suprasellar location. ⋯ Primary sellar melanocytic neoplasms are extremely rare lesions and present with few differential diagnoses. Deciding whether the tumor is best classified as a melanocytoma or a melanoma may prove difficult. Wide histological variations in both melanocytomas and melanomas render careful consideration of the clinical, radiological, and gross features essential in distinguishing one from the other.
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Comparative Study
Penetrating civilian craniocerebral gunshot wounds: a protocol of delayed surgery.
Several factors have led to our unique approach of delayed definitive débridement. We wanted to evaluate the effectiveness of our management and compare it with the existing data in the literature. ⋯ Our supportive care of patients is not optimal. We should have saved more of our patients who presented with GCS scores of 14 and 15 who subsequently died. We have been able to report unconventionally late surgical management of two-thirds of survivors, with no surgery in one-third of survivors. Despite a high rate of infectious complications, infection did not lead to death or disability. Our protocol rarely leads to patients surviving in a permanently vegetative state. In the future, we would perform early surgery for patients who present awake and continue our current management for poor-grade patients. In this way, we will improve the number of good outcomes without increasing the population of severely damaged and dependent survivors.
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To identify enduring prolonged neuropsychological effects of cerebral concussion in high school youth athletes. ⋯ There seem to be subtle yet significant prolonged neuropsychological effects in youth athletes with a history of two or more previous concussions.
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Comparative Study
Serial single-photon emission computed tomographic and transcranial doppler measurements for evaluation of vasospasm after aneurysmal subarachnoid hemorrhage.
To assess the clinical value of serial single photon-emission computed tomographic (SPECT) measurements after aneurysmal subarachnoid hemorrhage (SAH). ⋯ Serial SPECT measurements after aneurysmal SAH demonstrate that regional changes in cerebral perfusion follow a nonlinear time trend, and repeated measurements are necessary. This observation, as well as the low feasibility of SPECT, restricts the clinical value of such measurements.
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Comparative Study
Impact of coil embolization on overall management and outcome of patients with aneurysmal subarachnoid hemorrhage.
We report on the consequences of introducing coil embolization for the total management of and outcome in patients with subarachnoid hemorrhage (SAH). ⋯ The increasing use of coil embolization for ruptured aneurysms in the anterior circulation did not have any significant impact on the overall incidence of SAH-related complications or outcome. The main determinant for outcome after SAH is still the severity of the SAH.